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To the Editor.—
Thanks to Dr. Black for his interest in the newly observed syndrome "idiopathic pigmentation of the upper back."The condition is different from macular amyloidosis and has certain specific, even definite features. The patients are usually middle-aged women who are normal in every respect. No itching or other complaints occur, and the pigmentation involves the upper part of the back. No evidence of amyloid deposits or involvement of the skin or other body organs is present. The absence of amyloid in this entity was confirmed by the different amyloid staining characteristics. Macular amyloidosis itself is a doubted entity, and many authors failed to demonstrate amyloid deposits in the previously claimed cases. In addition, the incontinence of pigment is not unique to macular amyloidosis; it is present in many other skin diseases.The cases of "idiopathic pigmentation of the upper back" that we treat are many, and I
M. El Zawahry. Idiopathic Pigmentation of the Upper Back-Reply. Arch Dermatol. 1974;110(3):464. doi:10.1001/archderm.1974.01630090090030