Michelle Jones

A 37-year-old African American female presents with persistent dry cough and generalized fatigue that has been worsening over the last two months. She has had some mild dyspnea on exertion but denies any fevers or unexplained weight loss. She has had a few episodes that she had attributed to the intensity of her cough. On exam, patient has some diffuse intermittent wheezing and a dry cough. There are a few enlarged lymph nodes in the cervical and axillary regions. She additionally has tender, warm, red, and firm subcutaneous nodules on her bilateral pretibial surfaces.