Rectal examination was extremely tender diffusely without occult blood. The left midcalf has a 10 cm wide, circumferential ulcer with granulation tissue throughout. There is no erythema or discharge. The neurological exam is normal. The white count is 14.0 x 103 with 86 polys and 5 bands.
Liver enzymes are normal.
The left lower leg radiograph shows muscle calcification and new periosteal bone formation. The chest radiograph is normal.