A 26-year-old Hispanic male presented with numerous well-circumscribed red to purple colored papules on his chest, back, oral mucosa, genitalia and lower extremity. Case Summary Beginning below the right knee, the lesions become abundant and coalesce to form woody, indurated dark purple, brown and black plaques that cover most of the lower leg, ankle and foot. A large fungating nodule is visibly protruding from the medial aspect of the leg. The skin on the sole of the right foot is friable and exophytic. The patient has an ulceration on the plantar forefoot. Drainage from the ulceration is clear and malodorous.
There is non-pitting edema to the right lower extremity. Pedal pulses are audible via handheld Doppler. Sensation is grossly intact. The patient is unable to walk on the right foot secondary to pain. The patient’s vitals included the blood pressure of 120/55, a pulse of 111 per…
