Can You Diagnose This Malignant Lesion?

Tracey Vlahovic DPM

What is your diagnosis of the malignant lesion on the left?

This neoplasm is slow growing and rarely metastasizes. This lesion most commonly begins as a pearly, semi-translucent papule with telangiectasias. Over time, nodularity and central ulceration develop, and are accompanied by bleeding. The superficial form of this lesion presents as an erythematous, well demarcated macule, which clinicians frequently misdiagnose as eczema or tinea. More advanced forms of the lesion are friable and spontaneously bleed. Occurrence of this lesion on the lower extremities is quite uncommon.

Which of the following is your diagnosis?

a) Kaposi's sarcoma
b) Dermatofibrosarcoma protuberans
c) Basal cell carcinoma
d) Squamous cell carcinoma
e) Pyogenic granuloma

Editor's note: This blog is adapted from the handbook, Skin Disease Of The Lower Extremities: A Photographic Guide, from Tracey Vlahovic, DPM, and Stephen M. Schleicher, MD. The book is available for purchase at . The e-book version is available for purchase at , and .

The answer to the last blog ( ) is b) Erythema annulare centrifugum.

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