A 58-year-old woman presented with fever, fatigue, and skin lesions with a leopard-like appearance. The lesions first appeared 9 months earlier, and the dark pigment intensified over time. Her history included vitiligo and primary adrenal insufficiency, for which she was receiving hydrocortisone (10 mg per day) and fludrocortisone (0·1 mg per day). A CT scan showed splenomegaly and diffuse lymphadenopathy. What is the most likely cause of the skin lesions?
B) Inadequate hydrocortisone replacement
C) Cutaneous mycoses causing fever
D) Tuberculosis with cutaneous lesions
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