3 Weeks in Surgery — 68yo Man | General Surgery | SMLE Q#12125

SMLE Question #12125

Surgery General Surgery

Objective: OBJ-TRACH-EMERG-01

Last updated: February 2026
A 68-year-old man has had a painful skin lesion on the right anterior thigh for 3 weeks, starting suddenly and gradually enlarging. Examination shows a 3-cm, well-demarcated, bright-red, tender, slightly indurated plaque without fluctuance, discharge, or a palpable deep mass. He is afebrile and otherwise well. The clinician needs a definitive diagnosis to guide treatment. What is the most appropriate next investigation?

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