
Can you identify the cause of the hyperpigmented umbilicated lesions seen bilaterally on the patient's extremities and on her back?

Can you identify the cause of the hyperpigmented umbilicated lesions seen bilaterally on the patient's extremities and on her back?

The rapidly expanding lesion began as a small boil in the center of the ulcerated area 4 weeks ago. What underlying process do you suspect?

The lesions may mimic infectious, vascular, inflammatory and other ulcers; they do not respond to antibiotics and debridement often exacerbates the ulcer.

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