History: 63 yo WM with history of a verrucous pink plaque on his right great toe for over one year. It was not growing, itchy, or painful. He had no other similar lesions. Figure one depicts the lesion after shave biopsy. A portion of it remains distally.
Past Medical History: Hypertension, Hypercholesterolemia, Diabetes, Coronary Artery Disease
Medications: Hydrochlorothiazide, Lisinopril, Simvastatin, ASA, Metoprolol, Metformin
Physical exam: Verrucous pink plaque on the R dorsal great toe. Onychodystrophy and yellowing of toenails. Brown-purple reticulated macules and patches on bilateral dorsal feet and shins.
Click here for the diagnosis