Ulcer with an Undermined Edge

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?

A 50-year-old woman presented with this ulcerative lesion which she said began approximately one month ago as a small “boil” in the center of the now-enlarged area. She squeezed the initial lesion and treated it with topical antibiotic ointment. The lesion progressively expanded and became extremely painful.

What does this look like to you?

A. Vasculitis
B. Cutaneous manifestation of systemic lupus erythematosus
C. Pyoderma gangrenosum
D. Mycobacterial infection
E. Factitial ulcer
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