Pigmented Allergic Salute Sign in an Adult With Dark Skin: Clinical and Dermoscopic Features

TL;DR

This paper describes a rare pigmented skin condition in a dark-skinned adult caused by chronic allergies and nose rubbing.

Contribution

The paper documents a rare pigmented variant of the allergic salute sign in a patient with dark skin.

Findings

A 40-year-old woman presented with a hyperpigmented nasal band linked to allergic rhinitis and nose rubbing.

Dermoscopy showed features consistent with post-inflammatory hyperpigmentation in Fitzpatrick phototype VI skin.

The condition was differentiated from other pigmented skin disorders like lichen planus pigmentosus.

Abstract

Post-inflammatory hyperpigmentation due to chronic mechanical friction is well recognized in individuals with darker skin types, yet the pigmented variant of the allergic salute sign remains rarely documented. We report a 40-year-old woman with a persistent transverse hyperpigmented band over the nasal dorsum, associated with long-standing allergic rhinitis and recurrent conjunctivitis. She described habitual upward rubbing of the nose due to intense pruritus. Clinical examination revealed a sharply demarcated dark linear band above the nasal tip. Dermoscopy demonstrated a homogeneous dark pseudo-network with prominent follicular openings, consistent with post-inflammatory hyperpigmentation in Fitzpatrick phototype VI skin. Awareness of this presentation is essential to differentiate it from lichen planus pigmentosus or discoid lupus erythematosus. Management focuses on controlling allergic rhinitis, minimizing mechanical friction, and cautious use of depigmenting therapies. This case highlights the pigmented allergic salute sign as a distinctive marker of chronic allergic disease in patients with dark skin.

Figures