Lower extremity malignancies masquerading as ulcers

Ulcers of the lower extremities, particularly in individuals >65 years old, are a common cause for visits to the podiatrist, wound care specialist, primary care physician, vascular surgeon, or dermatologist. When an ulcer does not respond to adequate medical and wound care, the potential for an underlying malignancy should be considered. Cutaneous malignancies that may masquerade as ulcers include nodulo-ulcerative basal cell carcinoma, squamous cell carcinoma, keratoacanthoma, nodular melanoma, tumor stage mycosis fungoides, lymphomatoid granulomatosis, lymphomatoid papulosis, angiosarcoma, and cutaneous metastases from internal malignancy. It is crucial for healthcare providers to recognize these presentations and render appropriate therapeutic intervention.