A 64-year-old African American woman with a history of pancreatic cancer that had been previously treated with Whipple surgery, chemotherapy, and irradiation presented with a 10-month history of an enlarging lesion on the ventral surface of her right great toe.
Physical examination revealed an ambulatory woman with a 2.5 × 2.0-cm exophytic, hemorrhagic nodule on the ventral surface of the right great toe (Figure 1). A shave biopsy specimen was obtained (Figure 2 and Figure 3).