PUVA-induced pigmented macules: a case involving palmoplantar skin

A patient with palmoplantar psoriasis received a local treatment regimen of psoralens with long-wave ultraviolet A radiation (PUVA). After approximately 12 months of treatment, she developed hyperpigmented macules on her palms and soles. A biopsy showed changes consistent with PUVA-induced pigmented macules, as well as pronounced pigmentary incontinence. No cytologic atypia was noted. PUVA-induced pigmented macules should now be included in the differential diagnosis of palmoplantar hyperpigmented macules.