A 72-year-old man with a medical history of atrial fibrillation, type 2 diabetes mellitus, chronic kidney disease, hypertension, and congestive heart failure presented with a 2-month history of scaly erythematous papules on both forearms (Figure, A). The lesions were pruritic at times and the patient reported no improvement with chlorhexidine wash or hydrocortisone, 1%, cream. He was otherwise asymptomatic, and review of his systems revealed no abnormalities. His medications included amiodarone, furosemide, nifedipine, insulin glargine, and allopurinol. He denied preceding trauma, recent travel, or new medications.