Asymptomatic progressive symmetric telangiectatic patches of the extremities

A 30-year-old man with no significant medical history presented for evaluation of progressive discoloration of his bilateral legs, initially developing 12 years prior and recently spreading to involve the arms. There was no family history of similar lesions. Physical examination found symmetric, blanchable telangiectatic patches of the bilateral proximal lower extremities and milder involvement of the distal upper extremities (Fig 1). A dermoscopic image was obtained (Fig 2). Shave biopsy was sent for routine pathology (Fig 3).