brand logo

Am Fam Physician. 2022;106(6):709-710

Author disclosure: No relevant financial relationships.

A 13-year-old girl presented with a cut on her left foot that had been worsening for two weeks. The initial small scrape was immediately treated with neomycin ointment and covered. There was minimal pain at the site, but the patient had a low-grade fever the day before presentation. She had no bowel or bladder symptoms or joint pain. Her medical history included acne, seasonal allergies, and asthma.

Physical examination revealed a mildly tender ulcerative lesion measuring 3 × 3 cm on the dorsal aspect of the left foot (Figure 1). The lesion had raised borders with minimal surrounding erythema and induration. It had overlying eschar but no purulent discharge. The patient was afebrile, with normal heart rate and blood pressure. Laboratory test results were normal, including complete blood count, rheumatoid factor, complete metabolic panel, antinuclear antibody, and anticyclic citrullinated antibody.

Question

Based on the patient’s history and physical examination findings, which one of the following is the most likely diagnosis?

  • A. Allergic contact dermatitis.

  • B. Nummular dermatitis.

  • C. Pyoderma gangrenosum.

  • D. Squamous cell carcinoma.

Already a member/subscriber?  Log In

Subscribe

From $165
  • Immediate, unlimited access to all AFP content
  • More than 130 CME credits/year
  • AAFP app access
  • Print delivery available
Subscribe

Issue Access

$59.95
  • Immediate, unlimited access to this issue's content
  • CME credits
  • AAFP app access
  • Print delivery available
Purchase Access:  Learn More

The editors of AFP welcome submissions for Photo Quiz. Guidelines for preparing and submitting a Photo Quiz manuscript can be found in the Authors' Guide at https://www.aafp.org/afp/photoquizinfo. To be considered for publication, submissions must meet these guidelines. Email submissions to afpphoto@aafp.org.

This series is coordinated by John E. Delzell Jr., MD, MSPH, associate medical editor.

A collection of Photo Quiz published in AFP is available at https://www.aafp.org/afp/photoquiz

Continue Reading

More in AFP

More in Pubmed

Copyright © 2022 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions for copyright questions and/or permission requests.