Please help.  I am totally mystified by this.  For the last 3 days I
have been emitting a black, fine, tar-like residue from my
skin-primarily around the upper torso and armpit area.  It is much
like newsprint residue one might find on their hands after reading the
morning paper.  There is no odor evident.  I can take a baby wipe, rub
my chest with it, and the result will be prominent black streaks. I
took a bath and even left a black smudgy stain on the porcelain!  I
wore a white tee shirt to play tennis and it was stained black.  The
stain will not come out.  Today, I noticed that my sheets were stained
black around the area where my back rests against them.  This is just
plain weird.  I am a 45 year old caucasion male and in perfect health.  I just
had a complete physical.  I play competitive tennis and have never
smoked cigarettes--only a cigar and pipe occasionally.  I shower every
day, of course.  The only thing I can think of is that my girlfriend
gave me some detoxifying bath salts to use last week.  I only used
them once--is this reaction possible?  Where is this pitch-black
residue coming from?  Poisons from my own body!?  I work from my home,
so I'm not in a contributing environment--like working as a roofer or
something.  I can find no mention of this condition on the Internet. 
Am I in any danger?  When will this unpleasant experience end?  Any
ideas would be helpful...thanks.

Thank you for your question.

I am normally hesitant to answer medical questions here, since I am
not a doctor, and am not qualified to provide medical advice. In any
case you should not use this answer as a substitute for medical
advice.

Your question was intriguing, however, and I did forward it to a
doctor.

He mentioned that one condition that you may want to ask your doctor
to investigate is alkaptonuria, and he provided this information about
the disease:

Alkaptonuria facts
------------------

Alkaptonuria is an autosomal recessive disorder that results from
deficient activity of homogentisic acid dioxygenase (HGD), an enzyme
in tyrosine degradation. It was first described by Garrod in 1902.

HGD deficiency results in elevated levels of homogentisic acid (HGA)
which causes ochronosis, the deposition of dark pigment in connective
tissue. Patients usually are asymptomatic in childhood. In adulthood,
patients may have deposits of dark pigment in the ear cartilage and
sclerae (whites of the eye). Additional pigment is deposited in the
large joints and the spine, especially the lumbosacral region.
Calcification of multiple intervertebral discs is a characteristic
radiographic finding. This may lead to arthritis which is often
misdiagnosed as rheumatoid arthritis, osteoarthritis or ankylosing
spondylitis.

Axillary and inguinal areas may have a brown or black discoloration.
Perspiration can stain clothing.

The disorder is characterized by the excretion of urine that appears
normal when fresh, but turns dark brown or black if left standing. The
dark color is caused by oxidation of homogentisic acid.

Levels of HGA are increased in blood, urine, and tissue samples. The
diagnosis is confirmed by measurement of HGA in urine.

Dietary restriction of tyrosine and phenylalanine will reduce the
excretion of HGA, although the clinical effect is unknown.  Ascorbic
acid in large doses may be given but its efficacy in large series of
patients is unknown[1].

Patients with alkaptonuria tend to have a normal lifespan and die of
causes similar to the general population.

[1] Wolff JA, et al., Effects of ascorbic acid in alkaptonuria:
alterations in benzoquinone acetic acid and an ontogenic effect in
infancy. Pediatr Res 1989 Aug;26(2):140-4.

Related links:
--------------
Alkaptonuria: at http://www.emedicine.com/ped/topic64.htm

Alkaptonuria and Ochronosis: at
http://healthlink.mcw.edu/article/921733488.html

Alkaptonuria at the Health Cyclopedia,
http://www.healthcyclopedia.com/alkaptonuria.html

Search Strategy:
---------------
I asked a doctor who is good at identifying rare diseases. He searched
on alkaptonuria .

Disclaimer:
----------
Once again, this answer is NOT A SUBSTITUTE for examination by a
medical professional.

If you have any questions about this answer, please use the "Request
Clarification" button to solicit clarification or additional
information.

---

Clarification of Answer by rbnn-ga on 03 Nov 2002 09:54 PST

I just wanted to clarify that my answer is not  a diagnosis. It is not
possible to make a diagnosis without a physical examination and
consultation with a doctor. As stated in the answer, you might want to
ask your doctor about the disease, but only your doctor should provide
you with a diagnosis and treatment options.

I found this question to be very interesting and I waited for the
answer to be posted.  As a biochemist, I find the above answer to be
well researched and well communicated.

I do have a few questions of my own, however.  You have stated that
your health is excellent. Are you never-the-less taking any
medications?  Some meds and/or their metabolic products could be
excreted in your sweat and based on the pH of your sweat or other
bodily fluids , cause a colorless metabolite to become pigmented.

In addition to the above observations on pigmentation, have you
noticed any change in color or appearance of your urine?  Such changes
might also be the result of end product metabolites from ingested
foods or medications.

Stay well and let us know how things are going.

Hi Cal,

I did a little research on this for you earlier this morning. It looks
like you have a fine answer. Please don't consider my comment to be a
criticism of rbnn's answer!

Having said that, based on my research, it's possible that you have a
fungal or bacterial infection from whatever was in your bath salts.
Portions of your skin or some of your hair follicles my be infected.

In any case, I wish you a speedy recovery and I hope you will see a
physician soon.

fsw

Thank you all for your excellent (and rapid) response.  I'm checking
into all that was recommended.  To answer one question, no, I'm taking
no medication whatsoever.  Strange thing though, this morning
(Monday), there has been no staining.  I slept in a white tee-shirt to
see if there would be the usual "black newsprint" stains apparent on
my back and under arm area, but this morning was clean.  I'm beginning
to think I had some temporary reaction to the detoxifying bath
salts--but to have pitch black sweat emit from my pores--that's just
too bizarre.  My tennis whites from Friday are ruined, the stains
won't come out.  I'll be seeing a doctor next week just in case.
Thanks again. Cal

I'm curious too what it will be. Apparently alkaptonuria is so obscure
and difficult to diagnose though that it was once presented as a
puzzle in New England Journal of Medicine - and only 40 doctors in the
country could diagnose it!

I recently had a very similar experience, but it only affected my
fingernails, and only at the tips grown out beyond the nailbed.  I
could not wash it off, looked like newsprint.  lasted about a month. 
my legs also left a dark bluish-black stain on the toiletseat that
won't wash off to this day.  I suppose it might've been due to one of
the cat scan medications taken for a recent liver scan slowly working
it's way out of my system.  very bizarre.  maybe he should have his
liver checked.

Hello and thanks again, Rbnn-ga--I especially appreciate your
continued interest.  This is now day 6 and the last 2 days have been
stain-free.  I took the advice of your forwarded doctor "The
(Alkaptonuria) disorder is characterized by the excretion of urine
that appears normal when fresh, but turns dark brown or black if left
standing. The dark color is caused by oxidation of homogentisic acid."
 I left a urine sample standing for 24 hours and it did not change
color.  Then, earlier today, I once again bathed in the detoxifying
bath salts--to see if that was the cause, but I now appear normal. So
I guess is wasn't some chemical reaction to them. I am not crazy. My
girlfirend witnessed this very disturbing phenomenom, and has now
taken to calling me ALF. Very funny.  I'm keeping my soiled clothes to
give to a doctor next week, and truly hope there is an answer to this.
Now I'm thinking it's a metabolic issue as offered be researcher7-ga
(maybe I'm too acidic vs. alkaline).  I have no clue.  I haven't even
had a cold in over 6 years...