Age spots are areas of hyperpigmentation that appear on skin ... such as the backs of the hands and the tops of the feet, as well as the face, back, shoulders, and arms. They can be freckle ...

A 68-year-old woman presents with heaviness in her legs and feet, hyperpigmentation from the ankle to the mid-calf (the “gaiter” area), and swelling that is worse during afternoons and evenings.