Copyright © 2013 American Medical Association. All rights reserved. From: Primary Care Management of Non–English-Speaking Refugees Who Have Experienced TraumaA Clinical Review JAMA. 2013;310(5):519-528. doi:10.1001/jama.2013.8788 Figure Legend: Dermatologic Findings From Cultural Health Practices That May Be Incorrectly Identified as Signs of Torture or Physical AbuseA, In cupping, circular lesions occur on the skin as a result of the application of cups in which a vacuum has been created by heating the cups prior to application or by mechanical suction. The cups are left in place (stationary) or moved about (gliding). Petechiae and round ecchymotic marks from cupping typically last up to 3 to 7 days but hyperpigmentation can last longer. B, In coining, a smooth object (eg, coin, bone, jade, metal lid) is repeatedly rubbed on a lubricated area of skin until petechiae appear. The resulting skin lesions are typically linear and oriented in a direction away from the heart. The areas most often treated are the chest, back, and torso. Marks readily fade to ecchymosis and generally resolve in several days. Date of download: 12/16/2017 Copyright © 2013 American Medical Association. All rights reserved.