Have Black Pigmentation In The Middle Of Back And Shoulder Area. How To Remove This?

Posted on Sun, 24 Mar 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sun, 24 Mar 2013 Answered on

Wed, 17 Apr 2013 Last reviewed on

Question : I have some balck pigmentation in the middle of the back and shoulder area. Shoulders are not so intense but my back is a big patch. I'm east asian male of 48 and weigh 161 lbs.and am 5 ft. 6'' tall. I'm not diabetic and no family history either. Kindly help.

Answered by Dr. Tanusree Biswas (40 minutes later)

Hello,

Thanks for sharing your query with us.

Asian skin is prone to pigmentation. Some of the common causes of pigmentation in the area you mention may be:
1) Macular amyloidosis
2) Acanthosis Nigricans
3) Post inflammatory pigmentation
4) Melasma

There are other causes like lichenplanus pigmentosus etc which should be ruled out

I will be able to help you better if you can send a few pictures in good resolution. You can send them to

YYYY@YYYY

with subject as “ Attention : Dr Tanushree Biswas”

Please mention the symptoms, duration and if you have noted any aggravation factors.

Best wishes,
DR.TANUSHREE BISWAS

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Tanusree Biswas (1 hour later)

I have sent the pictures of my black spots to the email you specified. Hopefully you get them. Look to see your reply. Thanks.

Answered by Dr. Tanusree Biswas (17 hours later)

hello..
I have still not received your pictures.
Kindly resend them to YYYY@YYYY with the subject as 'ATTN DR.TANUSHREE BISWAS"

Please mention the symptoms, duration and if you have noted any factors that aggravate the pigmentation.
Have you scrubbed the area in an attempt to remove it?

Best wishes,
DR.TANUSHREE BISWAS

Above answer was peer-reviewed by : Dr. Mohammed Kappan

Follow up: Dr. Tanusree Biswas (6 hours later)

Uploaded.

Answered by Dr. Tanusree Biswas (44 minutes later)

Hello,
Thanks for following up.

I have seen the pictures you sent. From the pictures, I would put the diagnosis more in favor of Macular Amyloidosis.

Macular amyloidosis is a skin condition characterized by itchy, brown, rippled patches of pigmented skin in the body. Here there is a deposition of an abnormal extracellular family of proteins.

The cause of this is unknown. However certain things like scratching, rubbing, and all forms of friction increases this pigmentation severity.

The diagnosis is confirmed by a skin biopsy.

Treatment includes potent topical corticosteroids and systemic antihistamines. There are other office based treatment modalities like lasers, UV-B light which helps in this case.

You may visit a dermatologist and confirm the diagnosis by undergoing a skin biopsy. Take adequate sun protection and avoid any friction (like with towels, tight clothing, belts etc) to prevent this from increasing.

Hope this is helpful. I will be happy to assist you further if required.
Best wishes,
DR.TANUSHREE BISWAS

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Tanusree Biswas (6 hours later)

okay, but these spots are not itchy at all, so could it still be Macular amyloidosis? Could it also be a fungal infection caused by sweat?

Answered by Dr. Tanusree Biswas (8 hours later)

Hello,

Thanks for the follow up.

It is not necessary that Macular Amyloidosis is always itchy. So, it still could be Macular Amyloidosis.

I don't think it is a fungal infection. It is uncommon for a fungal infection to have similar presentation.

Best Wishes,
DR.TANUSHREE BISWAS

Above answer was peer-reviewed by : Dr. Mohammed Kappan