Persistent plaque with severe intermittent pruritus

Persistent plaque with severe intermittent pruritus
Persistent plaque with severe intermittent pruritus

A 32-year-old African-American man presented with a large, thick plaque on his right shin. The lesion had persisted for 10 months, despite having been evaluated by three physicians and treated with topical steroids, tacrolimus (Protopic) ointment, and oral antibiotics. According to the patient, the only treatment that had provided any relief was steroid injections into his hip. He also noted that the lesion would itch uncontrollably at times, although he would try to refrain from scratching. A previous biopsy had proven that the plaque was not cancerous.

What is the diagnosis?

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