Male patient, 52 years old, sought medical assistance complaining about the progressive appearance of hyperchromic papules on the lateral edge of the second finger of both hands for a period of 2 years. He also complained about the darkening of urine, sperm and underwear for 20 years with recent worsening. He was obese and hypertensive, currently using enalapril.
He already underwent some orthopedic procedures, such as knee arthroscopy, lumbar spine arthrodesis, and achilles tendon tenorrhaphy two, eight and fifteen years ago, respectively. Dermatological examination: A grayish spot in the sclera, grayish blue papules on the bilateral extensor surface of the second finger, periurethral hyperpigmentation, generalized chromonychia. Radiography of vertebral column showed calcification of lower and lumbar intervertebral discs, reduction of disc spaces and posterior arthrodesis with the…
