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Presents the clinical problem-solving column in which information about a patients is presented in stages to an expert clinician to responds to the information. Case of a 42-year-old woman with a history of asthma and irritable bowel syndrome who presented with pain and swelling of her feet and ankles associated with a rash on her lower extremities; Progress of her symptoms before presentation which included a 10-day-course of trimethoprim-sulfamethoxazole for presumptive sinusitis; Initial suspicions of the physician; Explorations of other medications the patient was taking and further personal history; Continuation of mild symptoms after treatment without diagnosis; Skin biopsy and results; Cat scan of the chest; Belief the patient suffers from tuberculosis.