Nonpruritic, painless, ashen blue-gray macules on the neck and trunk

A Hispanic woman, aged 30 years, presents with ashen blue-gray macules spread diffusely on her neck and trunk. The lesions are nonpruritic and painless, and no other systemic symptoms are noted. These lesions are concerning to the patient, since they developed sporadically 2 years ago and continue to worsen. On physical examination, blue-gray macules of varying sizes and shapes are ...