A 45-year-old African American woman presented with an asymptomatic rash that had worsened over the month prior to presentation. It initially began on the upper thighs and then spread to the abdomen, groin, and buttocks. The rash was mildly pruritic and had grown both in size and number of lesions. She had not tried any new over-the-counter medications. Her medical history was notable for late-stage breast cancer diagnosed 4 years prior that was treated with radiation and neoadjuvant

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... boplatin, docetaxel, and pembrolizumab. One year prior to presentation, she underwent a lumpectomy that was complicated by gas gangrene of the finger. She has been in remission since the surgery. Physical examination at the current presentation was remarkable for multiple well-circumscribed, hyperpigmented macules on the medial thighs, lower abdomen, and buttocks. Syphilis antibody screening was negative. WHAT'S YOUR DIAGNOSIS? a. erythema dyschromicum perstans b. lichen planopilaris c. lichen planus actinicus d. lichen planus pigmentosus-inversus e. postinflammatory hyperpigmentation Drs. Hoang, Downing, Rickstrew, Siscos, and Rajpara are from the Division