Derm Dx: Dark patches on the chin, trunk, arms, and thighs

A 32-year-old Hispanic female presents requesting treatment for “dark spots” on her chin, trunk, arms, and thighs. The condition first became apparent approximately 5 years ago and has not responded to a variety of topical medications prescribed while living in the Dominican Republic. Examination reveals multiple hyperpigmented patches of the affected areas (the circle is the site of a punch ...