case_images: PMC10894074_01
case_images: Multiple well-defined non-healing ulcers with pus oozing and crusting of various sizes present over bilateral lower limb at the time of admission.
case_images: cureus-0016-00000052960-i01.jpg
case_images: PMC10894074_01_cureus-0016-00000052960-i01.jpg
case_images: FIG1
case_images: Multiple well-defined non-healing ulcers with crusting of various sizes present over bilateral upper and lower limbs ranging from 3 x 3 cm and 5 x 5 cm (Figure 1).
case_images: PMC10894074_02
case_images: H&E stain of a biopsy taken from the perilesional site at the time of admission showing upper and papillary dermis showing intense inflammation and severe edema mixed with lymphocyte and neutrophilic infiltrate (black arrow).
case_images: cureus-0016-00000052960-i02.jpg
case_images: PMC10894074_02_cureus-0016-00000052960-i02.jpg
case_images: FIG2
case_images: Furthermore, a pus culture sent from the oozing wounds turned out positive for Staphylococcus growth and the punch biopsy taken from the edge of the ulcer margin of the lower limb which on histopathology showed neutrophilic infiltration (Figure 2).
case_images: Dermoscopic image taken from the healed patch over right thigh showing central depigmentation surrounded by a peripheral brown hyperpigmented rim with the absence of follicular opening.
case_images: cureus-0016-00000052960-i03.jpg
case_images: PMC10894074_02_cureus-0016-00000052960-i03.jpg
case_images: FIG3
case_images: Dermoscopic examination taken from a healing lower limb ulcer unveiled characteristic "Central depigmentation surrounded by a peripheral brown hyperpigmented rim with the absence of follicular opening" appearance (Figure 3).
case_images: Multiple well-defined healed hyperpigmented patches with central depigmentation of various sizes present over bilateral lower limb (after three weeks of treatment).
case_images: cureus-0016-00000052960-i04.jpg
case_images: PMC10894074_02_cureus-0016-00000052960-i04.jpg
case_images: FIG4
case_images: PMC10894074_03