An African American woman in her 30s presented with a 6-month history of 1-cm to 2-cm erythematous and scaly plaques on her lower legs associated with 30-kg weight loss. The plaques began around her ankles and spread proximally, reaching the upper thighs by the time of presentation. She also noted new lesions on her arms and abdomen in the preceding weeks. The eruption was asymptomatic, and the plaques were preceded by lower extremity edema and weakness, resulting in difficulty ambulating and frequent falls. The patient also reported allodynia, tingling, and numbness in her lower legs. She took no medications and her medical history was significant for a first-trimester miscarriage. She was a schoolteacher and had not traveled outside of the country in the past 10 years.