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A 4-year-old boy presents to urgent care with a new onset of a rash and toxic appearance. His caregiver says he became fussy and started refusing food about a week ago. Fever and malaise have persisted, despite use of liquid acetaminophen, and the rash appeared on his chest 3 days ago. Vitals are BP of 90/60 mm Hg, HR of 125 bpm, RR of 20 bpm, T of 102.1°F, and oxygen saturation of 97%. On exam, you identify a diffuse, maculopapular blanching rash on the chest, antecubital fossa, and anterior forearms with some desquamation at the fingertips. Sclera are clear, pharynx is slightly erythematous, tongue is somewhat swollen and red with pronounced papillae, and cervical lymph nodes are undetectable. What is the most likely diagnosis?
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