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Review Question - QID 214453

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QID 214453 (Type "214453" in App Search)
A 40-year-old man presents to a primary care provider with new onset rash. During review of social history, the patient reveals that he is sexually active with both sexes and uses inconsistent protection. He is also currently working at a pet shop. On physical examination, regional lymphadenopathy and cutaneous violaceous papules are found. Biopsy of these lesions reveals neutrophilic infiltrates. Labs reveal a CD4 cell count of 95 cells/mm^3. Which of the following characterizes the cause of the rash?