This patient is suffering from necrobiosis lipoidica. Treatment for this condition is limited and improvement is often slow. Topical steroids or tacrolimus are possible treatment options.

This is not an auto-immune condition and oral prednisone or cellcept are not appropriate. This lesion is not acutely infected and surgical revascularization would not be appropriate.

References:

Derm in Review Study Guide, Page 84, 2024.