An 87-year-old man presented to the dermatology clinic concerned about a gradual darkening of his bilateral lower extremities. The patient reported that he began developing blue-gray macules a few months prior to presentation.
The lesions have slowly continued to progress and do not spontaneously resolve. He denied pain, pruritus or known trauma to his legs.
The patient has a history of congestive heart failure and intermittent leg swelling, as well as chronic rheumatoid arthritis. The patient noted that he was on numerous medications, but was unsure exactly which medications he was taking and how long he had been taking them.
What’s your diagnosis?