This is a real Quiz and I don't have the answer.
This is a photo I took in Honduras of a woman's foot. It is resting on a wheelchair as she previously underwent a BKA (below the knee) amputation for complications of diabetes. She now had this strange, slightly ulcerated, non tender lesion on her foot for several months. You can see a smaller, less ulcerated lesion on her heel area.
I could not make a diagnosis without a biopsy. It did not appear infected, but certainly it could have been atypical TB. I also thought of necrobiosis lipoidica diabeticorum but it did not have the shiny typical features.
In Roatan there is no dermatologist nor did I have the means to do a biopsy with pathology. My final diagnosis was a pyogenic granuloma. Any ideas from you diagnosticians out there?