A 52-year-old African American woman presented with a 3-year history of a progressively thickening "black rash" on her toes and a 5-year history of tinea pedis. Five months before her initial visit, she underwent a total mastectomy for poorly differentiated infiltrating ductal breast carcinoma and had begun a course of chemotherapy (methotrexate, cyclophosphamide, and fluorouracil). She also had a 10-year history of type 2 diabetes mellitus, which was controlled by glipizide therapy.
Robinson C, Yee BYF, Kelly AP. Symmetrical Black Plaques on the Toes. Arch Dermatol. 2000;136(6):791-796. doi: