A 60-year-old bread seller with a background history of diabetes mellitus, hypertension and a previous unidentified abdominal surgery (which may have been an abscess) was seen by the orthopaedic team for chronic right big toe ulceration. A wedge biopsy of the ulcer was done and showed acute-on-chronic inflammation with fungal organisms. However, the orthopaedic team noted an incidental finding of hyperpigmentation over his lower limbs and referred him to dermatology
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