A 60-year-old female patient with Fitzpatrick skin type III presented due to a 10-year history of progressive hyperpigmentation on the lips, buccal mucosa, palate, and anogenital area. There were ...

He is otherwise healthy and takes no medications. On exam he has violaceous, slightly scaly papules on his wrists and forearms. His buccal mucosa exhibits white, lacelike patches. The ...