Image of the Week: Headache, Nausea, and Skin Discoloration

A 50-year-old man presents to the emergency department with a severe headache, nausea, and a 3-month history of diffuse gray-blue discoloration of the skin. Physical examination reveals a protuberant abdomen with a palpable liver edge that lies 4 cm below the right costal margin. Gray-blue hyperpigmentation of the face and neck is noted. Imaging demonstrates the findings seen here.

Which molecule is responsible for this patient’s skin discoloration?

Learn more about this case, take the quiz, and join the conversation on Figure 1.

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