Clinical Challenge: Purplish Patches and Plaques on the Legs

A patient aged 86 years presents with purplish patches and plaques on his lower legs. The lesions have been present for several years.

The patient was born in Greece but immigrated to the United States at age 20 years. He has type 2 diabetes, which is well controlled on metformin, and is HIV negative. A biopsy is performed.