Erythematous Pedunculated Plaque on the Dorsal Aspect of the Foot.

A 13-year-old adolescent girl presented for evaluation of a lesion on the dorsal aspect of the right foot of 1 week’s duration. She had a history of acne vulgaris and seasonal allergic rhinitis. She previously had noticed a persistent, small, flesh-colored bump of unknown chronicity in the same location, which had been diagnosed as a skin tag at an outside clinic. She denied any prior treatment in this area. Approximately a week prior to presentation, the lesion became painful, larger, and darkened in color before draining yellowish fluid. Due to concern for superinfection, the patient was prescribed cephalexin by her pediatrician. Dermatologic examination revealed a 1-cm, violaceous, pedunculated plaque with hemorrhagic crust on the dorsal aspect of the right foot with surrounding erythema and tenderness.