Hydroxycholoroquine-induced hyperpigmentation.

Area of Science:

• Dermatology
• Rheumatology
• Pharmacology

Background:

• Systemic lupus erythematosus (SLE) and Sjögren syndrome are chronic autoimmune diseases.
• Hydroxychloroquine is a common treatment for these conditions, known for its immunomodulatory effects.
• Drug-induced skin hyperpigmentation is a recognized, though infrequent, adverse effect of certain medications.

Observation:

• A 57-year-old female patient with a history of SLE and Sjögren syndrome was observed.
• The patient exhibited progressive blue-grey hyperpigmentation affecting the face, upper back, and dorsal feet.
• These dermatological changes emerged after seven years of continuous hydroxychloroquine treatment.

Findings:

• The clinical presentation strongly suggests hydroxychloroquine-induced hyperpigmentation.
• The distribution pattern of the hyperpigmentation is consistent with previously reported cases, though unusual in its extent.
• Histopathological examination (if performed) would be crucial for confirming the diagnosis and differentiating from other causes of skin discoloration.

Implications:

• This case underscores the importance of recognizing uncommon drug side effects in long-term therapy.
• Clinicians should consider hydroxychloroquine-induced hyperpigmentation in patients presenting with unexplained skin discoloration.
• Awareness of this adverse effect can aid in timely diagnosis and management, potentially involving dose adjustment or medication change.