Abstract
In Reply.— In my article, I referred to the work of Gilles et al, 1 who described lost pigmentation in African blacks with hookworm-induced iron deficiency. They made no note of greenish color of palms and soles in the affected patients, but remarked that pallor occurred only in patients with severe deficiency of blood albumin in addition to severe anemia. I did not state nor imply that melanin overlies hemoglobin in the epidermis. In the microanatomy of the skin, the vascular papillae (containing hemoglobin) protrude into the stratum basale (where most of the melanin resides). Thus, the points of color are not stratified one on the other; they intermingle as in photoengraving, where a mixture of tiny dots of blue and yellow is perceived as green. I welcome the references provided by Mr Cahan and salute his superior scholarship.
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