Notable Notes |

Reflections on the Hulk’s Green Skin

Leonard J. Hoenig, MD
Arch Dermatol. 2011;147(3):341. doi:10.1001/archdermatol.2010.417.
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One of the most popular comic book superheroes is the Hulk, whose mighty muscular physique is covered by strikingly green skin. Hulk also sports green eyes and greenish hair. Although the Hulk's verdant appearance was created by Stan Lee and Jack Kirby of Marvel Comics, his green skin does have its real-life counterparts. For example, a recent report described a 67-year-old jaundiced woman who developed intense green hyperpigmentation while receiving enteral tube feedings that contained FD&C blue No. 1.1 It was postulated that the blue dye in combination with the yellow jaundice produced the patient's greenish skin discoloration. Rarely, patients with hyperbilirubinemia may develop green skin changes caused by the cutaneous deposition of biliverdin.2

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