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Diltiazem-induced hyperpigmentation.
Tracy Kuykendall-Ivy1, Susannah Lambird Collier, Sandra Marchese Johnson
1Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock 72205, USA.
Cutis
|May 12, 2004
Summary
Facial hyperpigmentation in a 66-year-old woman resolved after discontinuing diltiazem. This case highlights a potential drug-induced skin reaction to extended-release diltiazem.
Area of Science:
- Dermatology
- Pharmacology
Background:
- Facial hyperpigmentation can be idiopathic or drug-induced.
- Treatment-resistant hyperpigmentation necessitates investigation into potential underlying causes, including medication side effects.
Observation:
- A 66-year-old woman presented with a 5-year history of facial hyperpigmentation unresponsive to standard topical treatments.
- Physical examination revealed hyperpigmented patches and papules on the face.
- Histopathology showed compact hyperkeratosis, follicular dilation, and dermal-epidermal inflammation with keratinocyte apoptosis.
Findings:
- The patient was taking extended-release diltiazem, rofecoxib, and pantoprazole.
- Discontinuation of extended-release diltiazem led to the gradual resolution of facial hyperpigmentation.
- This suggests a causal link between diltiazem and the observed dermatosis.
Implications:
- Extended-release diltiazem should be considered as a potential cause of drug-induced facial hyperpigmentation.
- Discontinuation of the offending medication is an effective treatment strategy.
- Further research may elucidate the specific mechanism of diltiazem-induced hyperpigmentation.