Congenital, Segmental Pigmented Lesions

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Abstract
REPORT OF A CASE A 64-year-old woman was evaluated at the University of California, San Diego, Medical Center for a lifelong history of pigmented macules involving her left arm, the left side of her chest, and the left side of her back and a 40-year history of multiple soft, asymptomatic, pigmented cutaneous papules involving the same locations. She had hypertension, which had been controlled with diuretic therapy, but she had no history of headaches, hearing loss, speech problems, or seizures. There was a family history of facial "freckling," but no family members had similar skin lesions. Physical examination revealed multiple 2- to 10-mm hyperpigmented macules distributed over the left side of the upper part of her back (Fig 1), the left side of her chest, her left breast, the medial aspect of her left arm and forearm, and her left axilla (Fig 2). In the same distribution there were multiple

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