The patients is a 48-year-old woman who presents with a single lesion on her cheek/face. As a healthcare worker herself, she says she is concerned that the excoriation might get infected. She denies knowing anything about the possible cause, but insists on receiving treatment.
Notably, she is a frequent visitor to your urgent care center in spite of the fact that she is in excellent physical health. However, she has been diagnosed with borderline personality disorder.
View the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.