The Backhand Index Pointing Up: Medium Skin Tone emoji is a modifier sequence combining ? Backhand Index Pointing Up and ? Medium Skin Tone. It is used as a single emoji on supported platforms.
Backhand Index Pointing Up: Medium Skin Tone was added to Emoji 2.0 in 2015.
U+1F446
U+1F3FD
?? White up pointing backhand index
?? Emoji modifier fitzpatrick type-4