A 58-year-old man presented to the outpatient dermatology clinic with complaints of spots on his legs. He reported that the spots had been present for a few years but stated that they had increased in size and had become pruritic over the last 6 to 7 months. He denied any other associated symptoms. He had no history of medical problems and did not take any medications. On physical examination, his bilateral anterior shins were noted to have several dark brown to black hypertrophic verrucous plaques arranged in a linear distribution. A shave biopsy of one of the lesions was performed, and the specimen was sent to pathology for analysis.
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