| Condition | Key features | Difference from “dirt” | |-----------|--------------|------------------------| | | Velvety, thickened dark patches; often in skin folds (armpits, neck, groin) | Texture is smooth/velvety, not scaly; associated with insulin resistance or obesity. | | Confluent and Reticulated Papillomatosis (CARP) | Reticular (net-like) dark spots on upper back/chest | Rare; often has a cobblestone texture; may respond to minocycline. | | Post-inflammatory hyperpigmentation | Dark marks after acne or folliculitis on the back | History of previous bumps/pimples; spots are flat and well-defined. | | Terrestrial melanosis (macular amyloidosis) | Rippled, brownish-gray patches on upper back | Itchy; caused by friction or chronic scratching. | | Poor hygiene (rare in adults) | Uniform darkening in skin folds or creases | Usually resolves completely after thorough washing with soap and a cloth. |

A continuación, se detallan las causas más frecuentes para este síntoma: 1. Dermatosis Terra Firma-Forme (Dermatosis de Duncan)

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