By Gary M. White, MD

Frictional melanonychia It is common to get a brown spot overlying notalgia paresthetica due to repeated rubbing/scratching.

Frictional melanosis (FM) describes the darkening of the skin in areas of chronic friction, usually over bony prominences. Common sites include over bones such as the elbow, clavicle, scapula, and vertebra. Histologic examination may be similar to postinflammatory hyperpigmentation. For related conditions, see frictional melanonychia and macular amyloidosis.


A hyperpigmented patch develops at the site of chronic scratching.


No treatment is needed. Stopping the rubbing/friction may allow for clearing over many months. Chemical peeling with both trichloroacetic acid (15%) and glycolic acid (50%) has been recommended for the treatment of frictional dermal melanosis of the forearms [J Cutan Aesthet Surg. 2015 Jan-Mar; 8(1): 37–41].


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