History:

Frictional melanosis a condition closely related to macular amyloidosis refers to a localized hyperpigmentation that develops at sites of repeated friction. It follows chronic vigorous friction or rubbing with a washing agent “rough piece of cloth” during bathing. The rash consists of rippled hyperpigmentation that mainly involves the skin over bony prominences e.g. over the clavicles, back especially scapular regions and upper arms. It causes significant cosmetic concern for afflicted individuals. This female presented with mottled hyperpigmentation over the upper back of 2 years duration. She admitted vigorous use of a hard washing agent on her back.