A 42-year-old African-American woman presented to an outpatient hematology-oncology clinic for follow-up after a bone marrow transplant with a chief complaint of pain in her extremities. Her medical history was remarkable for acute lymphoblastic leukemia positive for CD10, CD19, CD34, and Philadelphia chromosome. Ten weeks previously, she underwent a matched allogeneic unrelated donor bone marrow transplant. Her immediate posttransplant course was uneventful, and she was discharged to home 4 days prior to the current presentation. A physical examination revealed severe desquamation of her hands, legs, and scalp. She was subsequently admitted to the oncology ward with an initial diagnosis of graft-vs-host disease.