Pigmented patches in a pediatric patient

Abstract

A 10-year-old boy presented to an urgent care clinic with a 1-day history of asymptomatic lesions on his feet (Figures 1 and 2). He had a past medical history of seasonal allergies and exercise-induced asthma, and was on an albuterol inhaler, daily fluticasone nasal spray, and daily loratadine. The lesions were diagnosed as bruises, and a complete blood count was normal.Examination of photos of the involved areas during a teledermatology consult revealed irregular brown patches on the soles of his feet.