Abstract
A 60-year-old Muslim man was admitted to the Dhaka Hospital of ICDDR,B with an exacerbation of his chronic obstructive pulmonary disease. Incidental hyperpigmented skin lesions were noticed overlying the dorsum of his ankles, knees, and elbows. Such asymptomatic areas of thickened, lichenified and hyperpigmented skin are called 'prayer marks' and are well-imprinted on the knees, ankles, and forehead. These are secondary to prolonged periods of pressure over bony prominences during prayer. The patient's wife stated that the appearance of the elbow marks had coincided with an increase in his breathlessness and subsequent use of his elbows to rise from daily prayers. Prayer marks extending to the elbows could be a sign of worsening chronic disease.
Highlights
One of the five pillars of Islam is ‘Sallah’ which is the ritualized performance of prayers five times a day
The usual distribution of prayer marks is on the forehead, elbows, knees, and ankles (1)
During the treatment of the patient, hyperpigmented skin lesions were noticed overlying the dorsum of his ankles, knees, and elbows (Fig. 1-3)
Summary
One of the five pillars of Islam is ‘Sallah’ which is the ritualized performance of prayers five times a day. During ‘Sallah’, the devotee must perform ‘Sajdah’ which is a repeated prostration of the body involving the placing of the bare forehead, palms of hands, both knees, and the base of the toes upon the ground. These repeated and prolonged periods of pressure can lead to the appearance of asymptomatic, thickened, lichenified and hyperpigmented areas of skin. The usual distribution of prayer marks is on the forehead, elbows, knees, and ankles (1). The extension of prayer marks on to the elbows, to our knowledge, has not previously been described
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