Abstract
A woman in her 60s presented with 2 years of recurrent lesions on her lower extremities. Each lesion began as a mildly pruritic papule, which progressed to violaceous nodules, ulcerated with central eschar and healing spontaneously over approximately 3 months. Physical examination revealed 3 violaceous papulonodules on her distal right side of her lower extremity; 2 with black eschar formation, in addition to adjacent crusted papules and hyperpigmented macules (Fig 1). A punch biopsy (Fig 2) revealed a moderately dense infiltrate with numerous large, epidermotropic CD8+ (Fig 3), TIA-1+, and weakly CD30 positive lymphocytes with large pleomorphic nuclei and no evidence of angioinvasion.
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