There is a paucity of data on the epidemiology of dermatologic disease in populations with skin of color. Our objective was to compare the most common diagnoses for which patients of various racial and ethnic groups were treated at a hospital-based dermatology faculty practice. We reviewed the diagnosis codes of 1412 patient visits from August 2004 through July 2005 at the Skin of Color Center at St. Luke's-Roosevelt Hospital Center, in New York. New York, in whom race and ethnicity were recorded. The most common diagnoses observed during dermatologic visits by black and white patients were compared. The leading diagnoses observed during the study period differed between black and white patients. During visits by black patients, the 5 most common diagnoses observed at our center were acne (ICD-9 [International Classification of Diseases, Ninth Revision] 706.1); dyschromia (ICD-9 709.09); contact dermatitis and other eczema, unspecified cause (ICD-9 692.9); alopecia (ICD-9 704.0); and seborrheic dermatitis (ICD-9 690.1). During visits by white patients, the 5 most common diagnoses recorded were acne (ICD-9 706.1); lesion of unspecified behavior (ICD-9 238.2); benign neoplasm of skin of trunk (ICD-9 216.5); contact dermatitis and other eczema, unspecified cause (ICD-9 692.9); and psoriasis (ICD-9 696. 1). Although similarities were seen in the frequency of acne and eczema, conditions such as dyschromia and alopecia were commonly seen during black patient visits but were not among the leading 10 diagnoses made during white patient visits.