Extending prayer marks as a sign of worsening chronic disease

Prayer-Related Dermatoses in Muslims

Prayer rituals are an integral part of the daily lives of Muslims worldwide. This comprehensive review aims to explore the common dermatoses associated with prayer among Muslims and provide insights for dermatologists to facilitate accurate diagnosis and reduce unnecessary investigations. A systematic literature search returned 367 published articles, of which 21 met the inclusion criteria. Friction-induced dermatitis was the most frequently reported dermatosis, primarily affecting the forehead, knees, dorsum of the feet, and lateral malleoli. Friction-related marks often present as hyperpigmented lichenified plaques, and are more common in elderly individuals and males. Cases of contact dermatitis and fungal infections were also reported. Allergic contact dermatitis was linked to perfume application before Friday prayers, whereas fungal infections were attributed to increased water retention between toe webs, possibly related to communal ablution and prayer areas. Awareness of these prayer-related dermatoses enables dermatologists to provide holistic care for diverse populations and targeting specific interventions with respect for patients' religious beliefs. For example, Muslim patients with symptomatic frictional dermatoses may benefit from use of padded prayer rugs, especially diabetic patients whose lesions carry an increased risk of progressing to neuropathic ulcers.

A novel approach towards identification: A case report and review of literature

A primary objective of a medico-legal autopsy is to determine the identity of the deceased. The act of praying for prolonged periods of time can lead to the development of skin marks in Muslims, commonly referred to as "Naamaj signs" or prayer marks. An elderly male of unknown identity was brought dead to the hospital, where a post-mortem examination was performed. The patient's name in the treatment records suggested that the deceased was a member of the non-Muslim community, conflicting with the post-mortem examination report indicating circumcision and belonging to the Muslim Community. The disposal authority questioned whether cremation or burial was more suitable for the deceased. When it comes to cases involving religious identification, basing a decision on a single feature alone is not enough to permit the disposal of a deceased body. It is crucial to take into account other characteristics before determining the appropriate disposal method.

Pitfall prayer marks: Recognition and appropriate treatment: A case report and review of literature

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.