Patients with postinflammatory hyperpigmentation often complain of an asymptomatic dark spot or patch on the skin that seemed to appear “out of nowhere.” The spot may have blurred borders and may be irregularly shaped (Fig. 69-1; Fig. 2-2). Because any inflammatory dermatosis can heal with hyperpigmentation, the diagnosis of this condition is suggested by the history of a preceding rash that has evolved into a darker hue in the same distribution. Patients are often concerned that the darkening of color indicates a worsening of their condition; they need reassurance that the color change is actually a part of the healing process.