Painless, bruise-like hyperpigmentation on a woman with lupus

An African American woman, aged 50 years, presents with painless "bruises" on her leg. She first noticed bruises on both legs a year ago and reports that they have since become larger. Physical examination reveals blue-black macules and patches on both shins. The macules are asymptomatic, and the remainder of the physical examination is within normal limits. A venous stasis ...