13yo Hispanic pt presents with 1yr Hx of painful growth on t | Figure 1
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13yo Hispanic pt presents with 1yr Hx of painful growth on the dorsum of her foot. Cannot recall any previous injury. "Bump" keeps getting bigger, would like to have it removed. Exam revealed 1.2cm nodule with central ulceration. Exquisitely tender & erythematous with purulent discharge. Culture showed heavy Strep pyogenes. Lesion did not improve after course of keflex (recommended by ID pharmacist). Subsequently performed shave biopsy as palliative measure. Any guesses on dx before I reveal path findings?
Just appeared on tummy yesterday. No known exposures to irritants or bugs. Any ideas?