Vermilion hypopigmentation at an unusual site

Vermilion or kumkum powder is offered in south Indian Hindu temples as ‘prasadham’ (consecrated temple food) as a blessing especially for the female deity. It is both commercially available and homemade with the main ingredients being starch or chalk powder, turmeric powder, and azo dyes. Most women and some men apply this as a small round patch or as a horizontal or linear streak over the centre of the forehead. The remaining powder sticking to the finger tip is often applied by women over the hollow of the neck and over the sacred Thali (a chain with a gold coin or a thread soaked in turmeric paste tied around the neck at the time of marriage) that comes in contact with the chest and abdomen. Dermatitis and contact hypopigmentation is common at all these sites.