The patient is a 60-year-old woman who presents to urgent care after developing dark areas over both legs over the course of the past few days. They are extremely painful. On examination, there were violaceous and dark brown, retiform plaques, some depressed and some crusted, over the legs. The patient has a history of diabetes, hypertension, and chronic renal insufficiency for which she required hemodialysis.

View the image and consider what your diagnosis and next steps would be.

Dark painful plaques on legs
A 60-Year-Old Woman with Dark, Painful Plaques on Her Legs