IJWD Image Quiz Challenge

Images in Women's Dermatology Quiz

What is the most likely diagnosis?


A 28-year-old woman developed erythema, swelling, pain, and pruritus on the dorsal aspect of her toes bilaterally (Fig. 1A). During the 3 weeks that followed, these lesions progressively became more painful, developed vesicles, became dusky purple-red in color, and eroded superficially (Fig. 1B and C). The patient tried an over-the-counter antifungal medication without improvement. Two weeks before the onset of thetoe discoloration, the patient had experienced 3 days of low-grade fever and malaise. She was otherwise healthy.