“…Secondly, there could be a greater chance of exposure to potential offending chemicals due to any combination of religious, cultural or social reasons in this group of patients [7,8]. For example, the use of Bindi5 and Henna [9,10], which are important cultural and religious symbols to Indians, has been implicated in cases of Chemical Leukoderma. For affected Indian patients in India, other pertinent factors may come into play -a lack of regulation in manufacturing industries which results in common household items being produced with higher amounts of potential offending agents, such as pphenylenediamine (PPD) in hair dyes; hypopigmentation being misconstrued as harbinger of an infectious disease such as leprosy, or even "impurity", resulting in a higher rate of health-seeking behaviour [8].…”