A 29-year-old otherwise healthy man presented with a 12-month history of a slowly progressive nonhealing ulcer on his left fifth finger. He reported occasional pain in the finger but otherwise felt well. Physical examination revealed a 1.5-cm ulceration with surrounding erythema on the dorsal aspect of the left fifth finger (Figure 1). Two sterile punch biopsy specimens were sent for culture and histopathologic examination, respectively. Routine hematoxylin-eosin–stained sections are shown in Figure 2 and Figure 3).