A 43year old Caucasian female was seen in the intermediate care unit with a rash on her right lower leg. It had been there for the past ten years. She notes that it is usually painful but sometimes asymptomatic. It is seen as an ulcerative plaque with a predominantly atrophic, pale center interspersed with a yellowish hue, with irregular, violaceous borders. It is approximately 16×9cm. Her past medical history is significant for insulin-dependent type 2 diabetes mellitus, hypertension, and depression.
