Patients who have undergone coining or spooning present with multiple erythematous linear marks on the back and/or chest.¹,²

“Coining” (cao gio in Vietnamese) is an ancient medical technique that originated in the Far East. The practice survives today and may be seen in members of various Asian communities. Coining is used to treat ailments including asthma, viral illnesses, cough, nausea, and vomiting. This practice is seen most frequently among members of the Vietnamese, Chinese, and Laotian immigrant communities.

One popular method of coining involves massaging the skin first with a mentholated oil or ointment, then forcefully stroking the skin with the edge of a coin, a spoon, or a comb. This produces the eccymotic/petechial streaking that is pathognomonic of this technique.

The diagnosis is based on identification of the typical skin markings. It is important to obtain an adequate history, because the marks associated with these techniques may be mistakenly identified as indicative of child, elder, or spousal abuse.

Complications are rare but may include infection and scarring.

In most cases, no treatment is indicated, and evidence of coining is simply an incidental finding.