What Would You Prescribe for Chronic Skin Condition Resistant to Traditional Topical Therapies?

A 60-year-old female presents to her dermatologist with several years of persistent, asymptomatic lesions on her arms and legs. She has tried cryotherapy, topical therapies including topical retinoids and topical chemotherapy with no improvement.

On examination, the patient has multiple light pink slightly atrophic papules with dark pink raised borders scattered on the bilateral upper and lower extremities.