Acral Anomaly in a Young Boy

In the after-hours clinic you see a 3-year-old boy whose mother is concerned about a papular rash on the child's limbs, present for about 1 week. She also says he's been running a low-grade fever on and off for almost 2 weeks. PMH is non-contributory and there are no known sick contacts.What is your first impression on visualizing the rash? Are laboratory tests indicated? What's your diagnosis? Click through the slides below.