Drug-induced pigmentation in Adult
Increased melanin most often produces a brownish pigmentation in the dermis. When active compounds deposit in the dermis, however, there may be associated brown, red-brown, blue-black, or blue-gray discoloration. Drugs known to have such an effect are metals (eg, silver, gold, mercury, and bismuth), antimalarials, phenothiazines, amitriptyline, oral contraceptive pills, carbamazepine, gabapentin, lamotrigine, clozapine, amiodarone, clofazimine, minocycline, chemotherapeutic agents, and treatments for human immunodeficiency virus (HIV) suppression. Quinacrine causes a diffuse yellow color.
Agents used to treat HIV-infected patients have been shown to primarily cause skin and nail hyperpigmentation, and nail hyperpigmentation is one of the most common cutaneous side effects of antiretroviral therapy. Generally, hyperpigmentation caused by antiretroviral agents is dose-dependent and reversible.
A number of chemotherapeutic agents are also associated with hyperpigmentation, including carmustine, bleomycin, cisplatin, busulfan, doxorubicin, fluorouracil, hydroxyurea, mitoxantrone, vinorelbine, thiotepa, methotrexate, ifosfamide, cyclophosphamide, and docetaxel.
Related topics: Drug-Induced Flagellate Pigmentation, Amiodarone Drug-Induced Pigmentation, Minocycline Drug-Induced Pigmentation, Drug-Induced Hypopigmentation, Drug-Induced Oral Pigmentation, Drug-Induced Nail Pigment
T50.995A – Adverse effect of other drugs, medicaments and biological substances, initial encounter
110284009 – Drug-induced pigmentation
- Melasma (chloasma)
- Post-inflammatory hyperpigmentation has history of preceding inflammation.
- Fixed drug eruption
- Jaundice causes a yellow cast to the skin; it can also be drug induced.
- Hyperbilirubinemia can cause green to black secretion from pores (chromhidrosis).
- Carotenemia causes an orange color in the skin.
- Generalized hyperpigmentation is also seen in Addison disease, Cushing syndrome, scleroderma, Wilson disease, hemochromatosis, chronic renal failure, porphyria cutanea tarda, vitamin B12 deficiency, pellagra, ochronosis, Gaucher disease, and carcinoid syndrome.
- Erythema ab igne
- Ashy dermatosis (erythema dyschromicum perstans)
- Confluent and reticulated papillomatosis (Gougerot-Carteaud syndrome)
Nail and skin hyperpigmentation have been observed in HIV / AIDS patients independent of HAART. Thus, pigmentary alteration in this population may be especially difficult to attribute to drugs.
Last Updated: 01/09/2017