A 27-year-old woman presented with a 5-year history of bilateral leg pain, purpura, patchy ulcerations, skin pigmentation, and edema (Figures 1 and 2). A chart review found her course clinically progressive despite empiric treatment with steroids and anticoagulants for what seemed to be vasculitis-induced ulcers.Laboratory analysis found normal results for the following: complete blood count, complete metabolic panel, sedimentation rate, C-reactive protein, rheumatoid factor, antinuclear antibodies,...