A 70-year-old woman who loves to garden has small, flat, brown macules over her arms and hands. She asks, "What causes these liver spots?" Which is the best response by the nurse?

A) "They are signs of decreased hematocrit r/t anemia."
B) "Those are due to the destruction of melanin in your skin from exposure to the sun."
C) "They are clusters of melanocytes that appear after extensive exposure to sunlight."
D) "Those are areas of hyperpigmentation r/t decreased perfusion and vasoconstriction."

Liver spots, or senile lentigines, are clusters of melanocytes that appear on the forearms and dorsa of the hands after extensive sun exposure. The other responses are not correct. People with anemia will normally present with pallor. Melanin gives brown tones to the skin and hair so a decrease in melanin would produce a lightening of the skin. Decreased perfusion and vasoconstriction do not cause hyperpigmentation. The small, flat, brown macules over this patient's arms and hands are liver spots, or senile lentigines.