An 82-year-old man with diabetes presented with a nonhealing, painless ulcer on his foot that had been present for 1 year (Fig 1, A). The lesion had been previously treated with topical therapy because of the clinical suspicion of diabetic ulcer. A nonhomogeneous, brownish hyperpigmentation was visible around the ulcer (Fig 1, B). In addition, 3 asymptomatic, sharply demarcated, purple-red nodules of firm consistency were noticed on the medial arch of the same foot (Fig 1, C).
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