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Download the article PDF: Clinical Image Challenges January 2026
A 53-year-old woman visits urgent care for dark patchy spots on her neck and face that have been spreading over the past 3 months. The lesions are not painful or itchy, she denies exposure to allergens or irritants, and has no systemic symptoms. The patient states that sun exposure darkens the spots further and she has not tried any treatments to date. On examination she appears well with normal signs; hyperpigmented gray macular patches are seen on the chin and bilateral neck.
View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
53-Year-Old Woman With Dark Patchy Spots on Face and Neck
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