Black spots on the fingers, back, and other parts of the body can have several causes, and the fact that they did not improve with medicines like fluconazole suggests that it may not be a fungal infection. Common reasons include post-inflammatory pigmentation (dark marks left after previous rashes, acne, or itching), sun exposure, allergic or contact dermatitis, or conditions like friction-related pigmentation. In some people, vitamin deficiencies, hormonal changes, or certain medications can also lead to darkening of the skin. Less commonly, conditions like insulin resistance (seen in diabetes) can cause darker, thicker skin in certain areas. Since the spots are persistent and not responding to antifungal treatment, it is important to get a proper skin examination by a doctor to identify the exact cause. Treatment depends on the reason and may include medicated creams, sun protection, and correcting any underlying issues. Avoid self-medicating with multiple creams, especially steroid combinations, as they can sometimes worsen the problem. Early proper diagnosis will help you get more effective and lasting results.