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In his reply to an editorial by Williams,¹ Dr Carter² argues for the legitimacy of using racial identification in dermatology. In support of this argument, he cites the lower incidence of basal cell carcinomas and the higher incidence of postinflammatory hyperpigmentation among blacks. The question remains, however, whether these differences are due specifically to race or simply to the degree of skin pigmentation.

The reason that "blacks" have fewer basal cell epitheliomas than "whites" in the United States is most likely related simply to their level of skin pigmentation per se. In other words, race is a spurious factor. I believe that the same rarity of basal cell epitheliomas would be found in a population of equally dark-skinned individuals of non-African descent, such as inhabitants of the Indian subcontinent. I expect that the same would be true of postinflammatory hyperpigmentation.

One must not fall into the trap of equating race . . . [Full Text of this Article]

Stephen E. Silver, MD
Manitock Hill
63 Rock Ridge Rd
Waterford, CT 06385

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