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August 1983

`Acid Skin' in Black Patients

Author Affiliations


USAF Section of Dermatology, Department of Medicine Keesler USAF Medical Center Keesler AFB, MS 39534

Arch Dermatol. 1983;119(8):627. doi:10.1001/archderm.1983.01650320001001

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To the Editor.—  Several black patients requesting treatment for "acid skin" have been seen in our clinic. Since we were unfamiliar with this term, we interviewed and examined 30 consecutive patients who described their skin eruptions in this manner. All patients were black men ranging in age from 17 to 30 years. They came from different regions of the United States and had learned about "acid skin" from a close friend or relative. All believed the condition was caused by excessive dietary intake of such acidic foods as tomatoes, citrus fruits, and soda drinks.These patients had one of two distinctive clinical manifestations. Twenty-seven had scaly, guttate, and coalescent hypopigmented patches on the neck and shoulders. Clusters of spherules were seen on microscopic examination of skin scrapings that were mounted in potassium hydroxide solution. These patients had tinea versicolor, which responded to topical treatment with 2.5% selenium sulfide or 25%

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