RT Book, Section A1 Collier, Sigrid M. A1 Krejci-Manwaring, Jennifer A1 Usatine, Richard P. A2 Usatine, Richard P. A2 Smith, Mindy A. A2 Mayeaux, Jr., E.J. A2 Chumley, Heidi S. SR Print(0) ID 1164348673 T1 Postinflammatory Hyperpigmentation T2 The Color Atlas and Synopsis of Family Medicine, 3e YR 2019 FD 2019 PB McGraw-Hill Education PP New York, NY SN 9781259862045 LK dermatology.mhmedical.com/content.aspx?aid=1164348673 RD 2024/03/28 AB A 7-year-old African American girl was brought to her family physician by her mom, who was worried that she was itching and that her skin was getting darker. The physician knew the girl well as a patient with asthma and allergic rhinitis. In fact the girl performed the allergic salute more than once in the office as she rubbed her itchy nose. Morgan-Dennie lines were seen under her eyes (Figure 207-1A). The mom undressed the girl to show the dark patches of skin around her knees (Figure 207-1B). Atopic dermatitis is common in the popliteal fossae, and this girl clearly demonstrated the atopic triad: atopic dermatitis, asthma, and allergic rhinitis. The darkening of the skin around the knees and also seen on the neck is related to the scratching and rubbing of the skin secondary to the pruritus of atopic dermatitis. The physician explained to the mom and child about the need to more aggressively treat the atopic dermatitis with emollients and topical steroids. No promises were made about the reversibility of the hyperpigmentation, as each patient will respond differently to treatment.