A 16-year-old adolescent boy presented with a 2-year history of an expanding, dark eruption involving the chest, abdomen, axilla, and upper extremities. There was no pruritus or other associated symptom. Physical examination revealed hyperpigmented patches with minimal overlying scale in a confluent pattern on the lower chest and upper abdomen (Figure 1). A symmetrical, reticulated pattern of similar hyperpigmented patches was appreciated on the outer pectoral regions, axilla (Figure 2), and upper extremities.
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