Derm Dx: A large ulceration and tortuous varicosities

A 90-year-old woman presents for evaluation and treatment of an ulceration that has been on her left leg for >1 year. The ulcer had been ascribed to venous insufficiency and was treated conservatively elsewhere. The patient's medical history is positive for hypertension, hypercholesterolemia, and breast cancer. Physical examination reveals sparse, superficial, bluish, tortuous varicosities in many places on the left ...