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JAMA Dermatology Clinicopathological Challenge
October 2014

Bruising in a Man in His 60s

Author Affiliations
  • 1Medical student at University of Louisville School of Medicine, Louisville, Kentucky
  • 2Division of Dermatology, University of Louisville School of Medicine, Louisville, Kentucky
JAMA Dermatol. 2014;150(10):1109-1110. doi:10.1001/jamadermatol.2014.981

A white man in his 60s with a history of hypertension presented to his dermatologist with a bruiselike rash of 2 months’ duration. He was referred by a hematologist-oncologist whom he had seen for mild erythrocytosis and ecchymoses. The rash was not symptomatic and appeared mostly on the left side of his face and trunk. He had not experienced any trauma in the area. Initially, the bruiselike rash would appear and then spontaneously regress, but it was becoming progressively more persistent. The patient had no history of arsenic or radiation exposure and did not report any accompanying symptoms, including night sweats, fevers, chills, or weight loss. His medications included amlodipine besylate, benazepril hydrochloride, metoprolol tartrate, lisinopril, and over-the-counter daily vitamins.

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