A 62-YEAR-OLD MAN came into our facility for a skin exam at the urging of his wife. They were both concerned about a rash on his legs that was asymptomatic and had gradually developed over the past few years.
The patient, who worked as a laborer, was not taking any prescription medications, vitamins, or herbal products. He didn’t smoke, drink alcohol, or use recreational drugs and denied having any fevers, chills, arthralgias, or night sweats. He indicated that his father had a basal cell carcinoma.
On physical exam, we noted some seborrheic keratoses and mild acne rosacea in addition to the rash on his legs. The rash itself consisted of nonpalpable, nonblanchable macules on the lower shins, ankles, and dorsal feet with sparing of the soles (FIGURE).
FIGURE
Nonpalpable rash
The rash on this 62-year-old man’s legs developed over several years. The nonblanchable macules on the lower shins, ankles, and dorsal feet spared the soles.
WHAT IS YOUR DIAGNOSIS?
HOW WOULD YOU TREAT THIS PATIENT?