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There clearly was no reputation for fever, weakness, weightloss, arthralgia, cough, dyspnea, or ocular issues. Past and genealogy and family history was insignificant, with no considerable medication history could be elicited. On evaluation, several reddish-brown, shiny, fast papuloplaques and nodules were present on the face, throat, and hands. There was clearly a reddish brown plaque with main depression and overlying prominent telangiectasia throughout the remaining perioral area. The lesio