Case 2:

Mr. YM is a 52 y/o male with a medical history significant for DM and HTN (both poorly controlled) who presents to your clinic with swelling, erythema, and tenderness slightly above his left lateral malleolus. He admits to increased fatigue, fevers, and anorexia. He cannot recall any trauma to the area, and he explains that the lesion has been present for approximately two weeks. He hoped it would “go away.” He explains that it hurts even more when he walks. The remainder of his medical history is unremarkable.

His physical exam is notable for a T of 101.2, HR 95, RR 18, BP 150/85. The lesion is approximately 10cm by 5 cm on the lower aspect of his left lateral shin. The area is warm, erythematous, and tender. There is no crepitance. The left foot appears to have more swelling than the right. There is a 2cm by 1cm shallow ulcer in the middle of the lesion. The remainder of the physical exam is normal.