A 48-year-old man came to the office with a pruritic lesion that had been on the dorsum of his hand for 2 months. He said that the lesion began as 2 flesh-colored papules that had coalesced to form a larger lesion.
He denied any recent trauma, foreign travel, insect bites, disseminated rashes, or systemic symptoms associated with the appearance of the lesion. His medical history was unremarkable, and he indicated that he’d otherwise been feeling well.
His physical exam was significant for a 6 cm, violaceous annular confluent plaque with a firm, slightly raised border (FIGURE 1). There was no visible scale.
FIGURE 1
Violaceous lesion on the hand
What is your diagnosis?
How would you manage this condition?