Fresh photographs taken during President Donald Trump’s Oval Office meeting with South Korean President Lee Jae Myung on 25 August show extensive bruising on the back of Trump’s right hand, reviving public scrutiny of the 79-year-old leader’s health. Earlier images from 22 August appeared to reveal makeup covering the same area. The White House referred reporters to a 17 July letter from physician Sean Barbabella that said the marks are consistent with “minor soft-tissue irritation from frequent handshaking” compounded by Trump’s daily aspirin, part of a standard cardiovascular-prevention regimen. The memo also disclosed that Trump had been diagnosed with chronic venous insufficiency—described as a benign and common vein disorder that primarily affects the lower legs—while ruling out deep-vein thrombosis, arterial disease, heart failure and renal problems. Press Secretary Karoline Leavitt reiterated that the president “remains in excellent health.” Medical specialists cited in subsequent reports noted that hand bruising is typically unrelated to venous insufficiency in the legs but can occur more readily in older adults or people taking blood thinners such as aspirin. According to the National Institutes of Health, chronic venous insufficiency affects roughly 150,000 new patients in the United States each year.