Clinical Challenge: Hyperpigmented Nodules on the Arms and Back

The patient is a 31-year-old Hispanic woman who is referred for evaluation of dark marks on her upper arms and back. The duration is several months, and she initially denied itching or traumatizing the sites. Medical history is negative for systemic disease. She is not taking any prescriptive medications but does use supplements. Examination reveals multiple hyperpigmented nodules of the ...