4th August 2020

An 86-year-old retired mine worker presents to the GP due to a lesion on her hand that she says is a wound that refuses to heal

An 86-year-old retired mine worker presents to the GP due to a lesion on her hand that she says is a wound that refuses to heal. She does not remember what caused the wound to develop; however, she says it has been there “for years”. On further enquiry, she has no known risk factors for skin cancer apart from having fair skin. Her past medical history is significant for lung cancer, which she received treatment for last year. The patch is itchy, and occasionally it bleeds. On examination you note a singular erythematous patch, 1.5 cm in size on the back of her left hand, that is dry and crusty, with no areas of hypo- or hyperpigmentation. Given this clinical picture, what is the most likely diagnosis? 

Select the SINGLE most appropriate option from the list below. Select ONE option only.