A 64-year old-woman with a history of hypertension and poorly controlled diabetes mellitus presents with these painful lesions on her legs that have slowly progressed for years. She is unable to tolerate compression. What is an appropriate next step?

A. Surgical reperfusion

B. Oral prednisone

C. Topical tacrolimus

D. Oral cellcept

E. Intravenous vancomycin

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This image is from The Full Spectrum of Dermatology: A Diverse and Inclusive Atlas.