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February 2013

Hyperpigmented Patches on Shins, Palms, and Soles—Quiz Case

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD; LORI D. PROK, MD

JAMA Dermatol. 2013;149(2):223. doi:10.1001/2013.jamadermatol.652a

A 54-year-old woman presented with a 2-year history of a mildly pruritic, golden-brown rash that first developed on her palms and progressed to her shins and soles. The patient's medical history and medications were unremarkable. Physical examination revealed dusky, reddish-brown patches on her bilateral soles and reddish-brown patches with scattered red puncta on the dorsum of her feet, shins, and palms (Figure 1 and Figure 2). Laboratory test results showed no abnormalities for full blood cell count, double-stranded DNA, antinuclear an-tibody, serum protein electrophoresis, and erythrocyte sedimentation rate. A shave biopsy specimen was obtained (Figure 3).

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