A 32-year-old female who is known to have ulcerative
colitis presents with a painful ulcer on her left leg. On examination you note
a large, deep ulcer superior to the left medial malleolus. The skin
surrounding the ulcer is discoloured, bluish black in colour and the edges of
the ulcer are undermined. A biopsy is taken and this demonstrates an intense
infiltration of neutrophils and vasculitis.
In this patient which of the following medications would
you use as first line treatment?