Small brown spots on the lower shins

A white man, aged 55 years, presented with several discrete, well-demarcated, atrophic, hyperpigmented, nonblanching brown macules on the pretibial aspect of both lower legs. The spots appeared several years ago with no precedent trauma and are asymptomatic.

Neither OTC topical 1% hydroquinone nor 1% hydrocortisone cream had improved the color or number of lesions. The man had been diagnosed with ...