A Woman With a Hyperpigmented Macule on Her Wrist

Answer: E, no treatment is needed.

In certain areas of the world, particularly Egypt, Christians often differentiate themselves from members of other religions by applying a small tattoo to their bodies. Common areas include the flexor or extensor aspects of the wrists, the anterior forearm, the deltoid region, and the forehead.

The symbol on this patient’s wrist is known as the Coptic cross and is used by Coptic Christians to outwardly express their faith, identify other believers, and even gain access to religious sites. Coptic cross tattoos are administered to children as young as 2 months of age.

Since this is a tattoo and not a dermatological pathology, no further workup or treatment is warranted.