Question: Can you identify this condition?

Irina Turchin; Benjamin Barankin

A 68-year-old man presents with an erythematous rash on his upper chest (Figure 1) and cheeks (Figure 2). He developed the rash 6 months ago and is now concerned about its appearance and spread to adjacent areas. He says that 2 weeks ago he noticed his right arm had a mottled appearance (Figure 3). He has been taking lisinopril, hydrochlorothiazide, and enteric-coated aspirin since a heart attack 2 years ago. Results of his physical examination are unremarkable except for the cutaneous changes. Results of laboratory investigations were all found to be within normal limits. A chest x-ray film did not reveal any abnormalities.