Necrobiosis lipoidica

QUESTION 36

A 64-year-old Caucasian woman with a history of hypertension, rheumatoid arthritis and poorly controlled type II diabetes mellitus presents for evaluation of colour changes on her left foot. She states that it began as a small papule on her foot that grew larger, with some areas of ulceration. Because of her diabetes, she reports decreased sensation throughout her lower extremity. On examination, there is a yellow-brown plaque on the dorsum of her left foot with mild erythema and telangiectasias (36).