Department of Dermatology, University Hospital Basel, Basel, Switzerland.
Department of Pediatrics, University Hospital Bern, Bern, Switzerland.
Dermatol Ther. 2020 Jan;33(1):e13176. doi: 10.1111/dth.13176. Epub 2019 Dec 20.
Prayer marks are asymptomatic callosities resulting from repeated, extended pressure, and friction exerted on bony prominences when praying on hard ground. A 41-year-old woman with ulcerative colitis treated with infliximab was referred to our clinic due to skin changes on her feet that were suspected to be drug eruptions. The patient presented several asymptomatic, hyperpigmented, and hyperkeratotic plaques over the lateral malleoli suggesting that the lesions had a mechanical cause. Further exploration revealed that the patient, a practicing Muslim, prays in a sitting position called "Julus" several times a day. After color marking, the lesions over the lateral feet left a precise imprint on the underlay when the patient was asked to imitate the praying posture-thus proving the origin of the skin lesions. We searched the database on July 31, 2019 using the terms «prayer marks» OR «prayer nodules» OR "prayer callosities." Only electronically available publications were reviewed. Recognition of prayer marks is important to avoid misdiagnosis, performance of unnecessary diagnostic procedures, and to enhance the intercultural competence of clinicians who practice in multicultural societies.
祈祷斑是由于在坚硬的地面上祈祷时，骨头突起处反复受到长时间、过度的压力和摩擦而形成的无症状胼胝。一位接受英夫利昔单抗治疗溃疡性结肠炎的 41 岁女性，因足部皮肤变化而被转至我们的诊所，这些变化疑似药物疹。患者的外踝有几个无症状的色素沉着、角化过度斑块，提示这些病变有机械性原因。进一步探查发现，患者是一位虔诚的穆斯林，每天多次以一种叫做“Julus”的坐姿进行祈祷。当要求患者模仿祈祷姿势时，外足的病变部位出现了清晰的压痕，证明了这些皮肤病变的起源。我们于 2019 年 7 月 31 日使用“祈祷斑”或“祈祷结节”或“祈祷胼胝”等术语在数据库中进行了搜索，仅审查了可在线获取的出版物。识别祈祷斑对于避免误诊、不必要的诊断程序以及提高在多元文化社会中行医的临床医生的跨文化能力非常重要。
