The patient was an 80-year-old man who complained of recently noted dark purple blotches on the backs of his hands and extensor surfaces of his forearms. The lesions, which had increased in size and number since he was hospitalized for atrial fibrillation, were not painful or pruritic. There was no history of trauma. He wondered if the skin discoloration was a sign he was allergic to one of a number of medications prescribed during his hospital stay.

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