A 72-Year-Old Female with Lesions on Her Lower Legs

The patient is a 72-year-old woman who complains of multiple skin lesions on her lower legs. She says she first noticed them several months ago, appearing in a net-like pattern, then becoming painful ulcerations, and finally leaving atrophic scars. She is concerned because she had already had several bouts of deep vein thrombosis.

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