Austin J Surg. 2018; 5(5): 1141.
Bhargava R¹* and Bhargava M²
¹School of Psychology, Cardiff University Brain Research Imaging Centre (CUBRIC), UK
²Internal Medicine, Aster Medicity, India
*Corresponding author: Bhargava R, Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, UK
Received: February 27, 2018; Accepted: March 05, 2018; Published: March 12, 2018
A 65 year old asymptomatic man came for routine follow up in the hypertension clinic. There was no significant past medical history except for hypertension, for which he was on Amlodipine 5mg once a day for the last 10 years. No allergies were documented. However, he was noted to have a hyper pigmented macula (Figure 1) on the centre of the fore head.
The patient’s history revealed that it was a result of him kneeling and praying 5 times a day with his forehead touching a prayer mat since early childhood. He had developed these 5 years ago. This hyper pigmented macule is the result of the forehead’s repeated contact with a prayer mat . These prayer marks are also found in other locations due to sustained pressure of bony prominences; such as the knees, ankles and dorsum of the feet. They are more common in men and can lead to chronic skin changes such as hyper pigmentation, thickening and lichenification . It has also been noted that prayer marks herald the onset of new disease and worsening of chronic disease [2,3].
Figure 1: Overall survival, autologous stem cell transplant (ASCT) versus no ASCT (p=0.12).
The societal significance of these prayer marks are that they are considered a symbol of submission to God’s will. It is also thought that on the Day of Judgment light will emanate from these marks. Amongst the practicing Muslims it is considered a sign of devotion. Hence, we have called it the ‘Devout sign’ . From a medical perspective it is serves as a differential for hyper pigmented macules based on a patient’s history including religious habits .
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- Cangiano M, Chisti MJ, Pietroni MA, Smith JH. Extending prayer marks as a sign of worsening chronic disease. J Health Popul Nutr. 2011; 29: 290–291.
- Magdi Abdelhadi. “Signs of division on Egypt’s brow”. BBC News. 2008.
- Orenay OM, Sarifakioglu E. Prayer Mark on the Forehead: Hyper pigmentation. Ann Dermatol. 2015; 27: 107-108.