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Drug-induced pigmentation in Child
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Drug-induced pigmentation in Child

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Contributors: David O'Connell MD, William Schaffenburg MD, Susan Burgin MD
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Synopsis

Drug-induced pigmentation or dyspigmentation represents 10%-20% of all cases of acquired hyperpigmentation. Mechanisms of drug-induced pigmentation include cutaneous deposition of the drug or its metabolites, accumulation of melanin, deposition of iron, or synthesis and deposition of special pigments such as lipofuscin. Increased melanin produces brown pigmentation. When medications are deposited in the dermis, they can cause blue-black or muddy-brown macules. Drugs commonly associated with hyperpigmentation include NSAIDs, antimalarials, psychotropic medications, amiodarone, bleomycin, tetracyclines (most commonly minocycline), chemotherapeutic agents, and metals such as silver and gold.

Minocycline is of special note as it has been among the most widely used of these medications in adolescents. As minocycline is a primary antibiotic choice in the treatment of moderate to severe acne vulgaris, multitudes of patients have been exposed to this medication for durations long enough to experience some pigmentary side effects. Usually, the pigmentation develops after a year or more of therapy, but it has been reported to occur after just a few weeks to a couple of months.

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, Fixed drug eruption

Codes

ICD10CM:
L81.9 – Disorder of pigmentation, unspecified

SNOMEDCT:
110284009 – Drug-induced pigmentation

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 10/23/2019
Last Updated: 10/23/2019
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Drug-induced pigmentation in Child
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Drug-induced pigmentation : Hyperpigmented macules, Hyperpigmented patches
Clinical image of Drug-induced pigmentation
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