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Melena strongly suggests, and hematemesis confirms, that bleeding is of upper gastrointestinal originPeptic ulcer, the most common cause of gastrointestinal hemorrhage, should be pursued through questions about epigastric distress, the relationship of symptoms to food intake, and a history of peptic ulcer disease

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The ratio of eumelanin to pheomelanin is genetically determined by a number of factors including the degree of base-line functional activity of the enzymes and proteins driving the mixed melanogenesis, by the melanocortin 1 receptor (MC1R) genetic polymorphism, and by the amount of the tyrosine in the melanosome [6]