6th February 2024

A 40-year-old man presents with poorly healing leg cuts to his leg he suffered when playing football.

A 40-year-old man presents with poorly healing leg cuts to his leg he suffered when playing football. On examination, he appears to have a slowly healing wound, still bleeding and weeping. He also appears to have swollen and bleeding gums. He seems to have increased thickness and pigmentation of the skin surrounding his hair follicles and spiralling of hair, more prominently on his lower limb. 

His medical history is insignificant; he is a smoker and regularly lives on fried chicken and kebabs. He rarely has fresh fruits or vegetables. 

What is the most likely cause of his symptoms?