A 47-year-old Caucasian woman presented with a two-year history of asymptomatic, progressive skin lesions that had begun on the anterior lower legs and spread to the forearms and hands. The initial erythematous papules evolved into plaques that exhibited central atrophic, hyperpigmented, yellowish skin with telangiectasia and an active erythematous border. The woman’s non-insulin-dependent (type 2) diabetes, hyperlipidemia, and hypertension were managed with appropriate medical therapy.