CASE PRESENTATION
76 years male with a past medical history of Gastrointestinal Bleed, Anemia, Prostate Cancer status post prostatectomy and radiation treatment, Cutaneous T – Cell Lymphoma, Multiple Seborrheic Keratosis, Diastolic Heart Failure with LVEF: 55-60%, Aortic Valve Stenosis status post-BiPAP Prosthetic Valve Replacement, Coronary artery disease, carotid artery stenosis, hyperlipidemia, Type 2 Diabetes Mellitus, GERD, Hypothyroidism, Peripheral Arterial Occlusive Disorder was admitted with a complaint of dark colored stool for over a week. On investigation, Hemoglobin was below the normal range and a blood transfusion was done. He also had a history of multiple transfusions in the past. The patient gives no history of fever, chills, nausea, vomiting, diarrhea, chest pain, shortness of breath, or abdominal pain. The patient is married, a former smoker, an alcohol consumer and has no history of smokeless tobacco, vaping and recreational drug use. He has a known allergic reaction to penicillin. He was under several outpatient medications such as Alprazolam, Vitamin C, Aspirin, Carvedilol, Empaglifazon - Metformin, Ferrous Gluconate, Folic Acid, Levothyroxine, Losartan, Melatonin, Multivitamin Tablets, Nitroglycerine Sublingual, Pantoprazole and Rosuvastatin. A general physical examination revealed pallor and hypertension. Cardiovascular examination revealed crescendo- decrescendo murmur. Multiple seborrheic keratoses were present in the chest and back.