A 50-year-old Caucasian man came to the dermatology clinic with a tender growth on his great toe. He first noticed it a year earlier after sustaining trauma to the area. The growth had been getting bigger and had intermittently bled. It had also oozed, so his primary care physician treated it as an infection with topical antibiotics, followed by several courses of oral antibiotics.
Despite therapy, the lesion continued to grow and the patient was referred to us. The patient had a 3.4 cm × 1.8 cm exophytic erythematous nodule on the left lateral great toe (FIGURE).
What is your diagnosis? How would you manage this condition?
FIGURE Erythematous nodule on left great toe
Over the course of a year, the growth on this 50-year-old patient’s great toe grew, intermittently bled, and oozed. Topical and oral antibiotics were ineffective.
