Abstract
A 79-year-old man developed a grey-brown discolouration of his skin over 3 years; the pigmentation was most striking in the sun-exposed areas of his face, neck, and the backs of his hands. Lunulae of his nail beds were blue (figure). Tests for Wilson's diseases, haemochromatosis, bismuth toxicity, and renal insufficiency were negative. He was not taking any medicines that could lead to photosensitivity, nor did he use cosmetics.
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