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Hydroxychloroquine-associated hyperpigmentation mimicking elder abuse.

Philip R Cohen1

  • 1Division of Dermatology, University of California San Diego, San Diego, CA, USA, mitehead@gmail.com.

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Summary
This summary is machine-generated.

Hydroxychloroquine can cause skin discoloration, mimicking elder abuse. A case study highlights the importance of considering drug side effects and performing skin biopsies to avoid misdiagnosis in elderly patients.

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Area of Science:

  • Dermatology
  • Geriatrics
  • Pharmacology

Background:

  • Hydroxychloroquine use can lead to cutaneous dyschromia (skin discoloration).
  • Elder abuse victims may exhibit bruising and resolving ecchymoses, which can be mistaken for other conditions.

Purpose of the Study:

  • To describe hydroxychloroquine-associated hyperpigmentation.
  • To review skin and mucosal manifestations of elder abuse.
  • To summarize mucocutaneous conditions that mimic elder abuse.

Main Methods:

  • A case report of an elderly woman treated with hydroxychloroquine for systemic lupus erythematosus who developed drug-associated hyperpigmentation.
  • Clinical misinterpretation of the dyschromia as elder abuse, leading to notification of Adult Protective Services.
  • Confirmation of hydroxychloroquine-associated hyperpigmentation via skin biopsy.

Main Results:

  • Hydroxychloroquine-induced hyperpigmentation can present as black and blue skin discoloration.
  • The patient's condition was initially misdiagnosed as elder abuse.
  • Skin biopsy confirmed the drug-induced etiology, clearing the family of suspicion.

Conclusions:

  • Antimalarials like hydroxychloroquine can cause hyperpigmentation of the skin, mucosa, and nails.
  • Elder abuse is an underreported issue in seniors, and cutaneous findings can be indicators.
  • Differentiating drug-induced hyperpigmentation from elder abuse requires thorough medical history, evaluation, and potentially skin biopsy.