Idiopathic Pigmentation of the Upper Back

To the Editor.—  In the January 1974 issue of the Archives, El Zawahry¹ described a group of patients with "idiopathic pigmentation of the upper back," ignored a number of pertinent references, and erroneously concluded that he was describing a new syndrome.I would like to draw attention to the 1969 report of Gibbs and Frank² describing a similar group of patients with macular lesions of the back.In 1970, Shanon and Sagher³ described a similar eruption in patients with interscapular cutaneous amyloidosis and mentioned that in a group of 16 patients, in whom the same clinical picture of a pigmented reticular dermatosis on the back was observed, amyloid was not demonstrated in biopsy specimens of the affected area.In 1972, Hashimoto and I⁴ described a group of patients with macular amyloidosis, some of them showing the same clinical picture as described by El Zawahry. We also