REPORT OF A CASE
A 45-year-old man was admitted to the Houston (Tex) Veterans Administration Medical Center complaining of a 6-week history of subcostal and epigastric discomfort associated with shortness of breath, diaphoresis, and dyspnea on exertion. The patient had a 60-pack-year smoking history, consumed excessive amounts of ethanol, and had a strong family history of ischemic heart disease.A coronary arteriogram and cardiac catheterization showed severe ischemic disease with partial or total occlusion of multiple coronary arteries. Fourvessel coronary artery bypass surgery using autogenous right saphenous vein graft was performed. The surgery required transfusion of 3 units of packed red blood cells. The surgery and immediate postoperative course were uneventful.One month after surgery, the patient noted an asymptomatic eruption along the medial aspect of the right lower extremity at the graft donor site. He presented to the dermatology service 8 months after surgery with a tawny brown, poorly