What Is the Cause of This Patient’s Leg Discoloration?

figure 1

A 68-year-old woman presented for evaluation of persistent skin discoloration of her lower extremities that began 3 years ago. She denied associated chills, fever, pain, or pruritus.

figure 2

Her past medical history was significant for Parkinson disease, which had been managed with amantadine, carbidopa-levodopa, pramipexole, and rasagiline for 10 years. Physical examination revealed reticulated, erythematous to violaceous mottling of her lower legs and thighs without evidence of necrosis or purpura (Figures 1 and 2).

What's your diagnosis?

To learn the answer, go to page 2



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