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Case vignette A 9-year-old boy with no past medical history was admitted for severe epistaxis and aplastic anemia of unknown etiology with hospital course complicated by bacteremia and the development of a tender plaque on the forearm. Exam revealed a violaceous plaque with peripheral erythema and central necrosis on the left dorsal forearm (Fig 1). Punch biopsies for frozen section and tissue cultures were obtained.
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