Figure 1. Clinical presentation of a three-striped hyperpigmented patch located on the left lower back, expanding into the left middle back.

The patch has a streak located toward the lateral aspect giving clinical clues that ruled out idiopathic causes and narrowed toward self-induced phytophotodermatitis caused by the second, third, and fourth digits of the left hand touching the left medial back after being exposed to a photosensitizing agent such as a lime margarita that contained citrus.