Skin rash in a 41 yr old male | Figure 1

Warveen

Internal Medicine

Skin rash in a 41 yr old male

A man has been admitted to the medical ward for a chest infection. Upon physical exam, he was found to have this rash in form of light brown macules and patches involving mainly the trunk (neck, chest, abdomen, back) and upper portion of the arms, sparing other parts of his extremities including palms and soles, as well as the face. The rash has been present as long as he remembers since childhood and it is otherwise asymptomatic. He reports that it gets darker at some periods of time, then fades, but never disappears. Upon further inquiries, he reported a similar rash in his paternal aunts and his brothers, but none of his sisters.

What are the likely diagnosis and differentials for this rash?

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