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| I am perplexed and disturbed by the proposed limitations on hyroquinone. I have practiced Dermatology in private practice and at a teaching institution (University of Louisville) and in these capacities have managed a large number of African-American patients. In 23 years of practice, I have never seen, even at a meeting, a case of hyroquinone-induced ochronosis with agents available in the US. I have likewise never seen a cutaneous malignancy in areas where topical hydroquinones were used in darker skin. Please don't subject our profession and our patients to limitations on hyrdoquinones curently available based on THEORETICAL concerns. Placing limitations on products used primarily by patients of color without significant or solid scientific evidence of problems is not only illogical, it also gives the appearance of applying different criteria to products used by patients of color. Both a scientific and political backlash to these proposals will (and should) occur. Scientifically "scoffing" at the very real problems African-American patients have with persisting and at times disfiguring hyperpigmentation reeks of a double standard. Please reconsider the current proposal and base any future recommendations on sound science, not theory. Please let the dermatologic profession's expertise and experience assist in decisions regarding limiting availability of beneficial medications and modalities. "Fixing" hyrdoquinone availability which isn't "broken" and ignoring the catastrophic future consequences of unfettered availability of UVA tanning beds to minors indicates priorities at the Federal level which sorely need reexamination.
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