Violaceous-rimmed ulcers

Cindy Berthelot, MS, and Jennifer Clay Cather, MD

A 40-year-old man presented with a violaceous-rimmed ulceration on his inner thigh. He complained of crusting and drainage, but the lesion was otherwise asymptomatic. It began as a pimple, expanded into a small erosion, and then progressed to an ulceration. Medications at the time of presentation included prednisone and delayed-release mesalamine. What is the diagnosis? What are the therapy options?