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Jack L. Guccione, MD, MPH
Redwood Memorial Hospital, Fortuna, Calif

Arch Dermatol. 1999;135:845-850.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

REPORT OF A CASE

A 34-year-old Hispanic woman presented to her primary care physician with a 4-month history of a nonhealing ulcer on her left hand. She stated that she had initially cut her hand on a broken plate while washing dishes. She was treated with local wound care and systemic antibiotics for several months, without improvement. Radiographs and a bone scan revealed no evidence of osteomyelitis. Skin culture revealed nonpathogenic organisms including Staphylococcus epidermis and diphtheroids. The primary care physician then obtained a punch biopsy specimen, which was interpreted as squamous cell carcinoma. A plastic surgeon excised the lesion and preformed a skin graft. After 6 weeks, the skin graft sloughed and the ulceration returned. A second skin graft was performed and a similar process occurred in the ensuing 5 weeks.

The patient was then referred to the dermatology clinic for evaluation of the recurrent ulceration of the . . . [Full Text of this Article]

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