45-Year-Old With Painful Ankle Lesion

A 45-year-old woman presents to urgent care with a painful area that developed on her right ankle 2 weeks prior. The patient had a family history of venous thromboembolism. On examination, a variegated brown patch with a central pink angulated scar and an overlying thick crust on the lateral ankle was seen. There was also unilateral peripheral leg edema. On laboratory examination, anemia, thrombocytopenia and anticardiolipin antibodies were present.

View the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.