A 27-year-old white woman presented to the student health clinic with a 2-week history of an enlarging ulcerated nodule on the dorsum of her left wrist. In the weeks preceding the visit, she had worked in her garden and had traveled to the West Indies. There was no history of trauma to the area, and she denied generalized symptoms. She was otherwise well. The lesion started as a pinpoint red papule that ulcerated as it expanded in depth and width. The erythematous surrounding tissue was mildly painful. Also, within the prior 2 weeks, the patient had noted the appearance of several palpable nodules on the upper part of her left arm.
Saxena M, Rest EB. An Ulcerating Nodule on the Arm. Arch Dermatol. 1998;134(10):1279-1284. doi: