Abstract
A 21-year-old man presents for dark spots on the left arm. He states they first appeared 2 years ago and initially looked like pimples. He said over time they turned into small patches which soon turned tan and grew in size. He says for the past year they have been stable in size, but have gotten darker and thicker. He denies that they are pruritic or painful. He has tried topical steroids without improvement. The patient denied systemic symptoms including fever, unintended weight loss, or fatigue.
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