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An Update on Drug-Induced Pigmentation.
Amanda F Nahhas1,2, Taylor L Braunberger2, Iltefat H Hamzavi3
1Department of Dermatology, Beaumont-Farmington Hills, Farmington Hills, MI, USA.
American Journal of Clinical Dermatology
|October 31, 2018
Summary
Drug-induced pigmentation, a common cause of skin discoloration, is linked to numerous medications. Diagnosis requires careful review of drug history and skin examination to identify these pigmentary changes.
Area of Science:
- Dermatology
- Pharmacology
- Internal Medicine
Background:
- Acquired pigmentation can be attributed to drug-induced causes in up to 20% of cases.
- Identifying the specific causative agent is crucial for diagnosis and management.
Purpose of the Study:
- To review the spectrum of medications implicated in drug-induced pigmentation.
- To highlight diagnostic approaches and challenges associated with this condition.
Main Methods:
- Comprehensive review of medical literature on drug-induced pigmentation.
- Analysis of implicated drug classes, including cytotoxic agents, analgesics, and psychotropics.
- Discussion of diagnostic strategies involving patient history and dermatological examination.
Main Results:
- A wide array of medications can induce skin pigmentation.
- Key drug classes implicated include alkylating/cytotoxic agents, analgesics, antiarrhythmics, anticoagulants, antiepileptics, antimalarials, antimicrobials, antiretrovirals, metals, prostaglandin analogs, and psychotropic agents.
- Diagnostic confirmation is often complicated by delayed onset and polypharmacy.
Conclusions:
- Drug-induced pigmentation is a significant contributor to acquired skin discoloration.
- Accurate diagnosis relies on meticulous patient history, medication review, and skin assessment.
- Challenges in confirming drug associations necessitate a high index of suspicion.
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