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Home Topics A–Z Drug-induced hyperpigmentation
Author: Vanessa Ngan, Staff Writer, 2004.
Drug-induced skin pigmentation accounts for 10–20% of all cases of acquired hyperpigmentation. Pigmentation may be induced by a wide variety of drugs; the main ones implicated include non-steroidal anti-inflammatory drugs (NSAIDs), phenytoin, antimalarials, amiodarone, antipsychotic drugs, cytotoxic drugs, tetracyclines, and heavy metals.
Some drugs may cause fixed drug eruption, which is followed by localised hyperpigmentation and gradually fades.
Drug-induced pigmentation
Several mechanisms may be involved in the drug-induced changes of pigmentation of the skin.
The clinical features of drug-induced skin pigmentation are very variable according to the drug involved. A large range of patterns and shades may be formed.
Drug/drug group | Clinical features |
---|---|
Heavy metals |
|
Tetracyclines (minocycline) |
|
Antipsychotics (chlorpromazine and related phenothiazines) |
|
Phenytoin/anticonvulsants |
|
Antimalarials |
|
Cytotoxic drugs |
|
Amiodarone |
|
NSAIDs |
|
Drug-induced skin pigmentation can become cosmetically disfiguring. In many cases, once the offending drug has been stopped, fading of the lesions occurs. However, the pigmentation may last a long time or become permanent. Because many drugs that induce skin pigmentation also cause photosensitivity reactions, sun protection is usually recommended.
Laser treatment has been successful in treating amiodarone-induced skin pigmentation.
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