A young girl who has atopic eczema. Chronic scratching secondary to itchy irritated eyes resulted in post-inflammatory hyperpigmentation. Of note in this slide is scaling (increased stratum corneum) and the thickened skin of lichenification (chronic eczema/scratching). A build up of scale (dependent on the amount of retained melanin in the stratum corneum) can cause hyperpigmentation, although normal skin pigmentation might be present in the epidermis below the scale.