Journal of Urgent Care Medicine

Hyperpigmented Skin Patches

A 70-year-old man presents to an urgent care center after becoming concerned about brown hyperpigmented patches on his legs and arms. He says that he thinks some of his teeth are turning gray, but it has been happening so slowly that he is not sure. He reports that he has been in good health recently, especially after starting to take antibiotics last year to treat his rheumatoid arthritis. View the image taken (Figure 1) and …

Clinical Challenge: April, 2011

The patient is a 4-year-old child who presents after experiencing a blow to the forearm while taking a fall. He is other- wise well-appearing, and other than pain in the affected arm the examination is unremarkable. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.