Antimalarial cutaneous side effects: a study in 209 users

Antimalarial agents are commonly used drugs that may have skin side effects.

To study the prevalence of cutaneous side effects in antimalarial users.

We studied the prevalence of cutaneous manifestations in 209 antimalarial users, 127 with systemic lupus erythematosus (SLE) and 82 with rheumatoid arthritis (RA). As control we included 200 patients from the gynecologic and ophthalmologic departments who did not have antimalarial use. Patients were submitted to a structured questionnaire for demographic data, type of antimalarial drug used, and treatment time as well as skin complaints. Physical examination was performed by a dermatologist.

In 159 of 209 (76%) of the antimalarial users, there were cutaneous findings. The most frequent was xerosis, followed by skin hyperpigmentation and pruritus. In 4.8% of the antimalarial users, allergic reactions led to drug withdrawal. When comparing them with the control group, skin hyperpigmentation and xerosis were more prevalent (p < .0001 for both), but pruritus was not (p = .39). No relationship could be found between the skin side effects and ethnic background, gender, antimalarial type, or treatment duration. Hair depigmentation was more common in SLE patients than in RA patients.

Cutaneous side effects in antimalarial users are frequent. Xerosis and hyperpigmentation are the most common findings.