Related Experiment Video
Updated: May 12, 2026
05:26
Author Spotlight: Oral Candida Diagnosis to Advance Clinical Treatment Regimen for pSS Patients
Published on: March 1, 2024
920
Case Report: Scleral hyperpigmentation associated with oral hydroxychloroquine use.
Caroline Maretz1, Felix Omoruyi1, Rachel A F Wozniak1
1Department of Ophthalmology, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States.
Frontiers in Ophthalmology
|July 10, 2024
Summary
Hydroxychloroquine (HCQ) can cause blue-gray skin and scleral hyperpigmentation. Stopping the drug may reverse this side effect, increasing awareness of HCQ drug reactions.
Area of Science:
- Ophthalmology
- Dermatology
- Pharmacology
Background:
- Hydroxychloroquine (HCQ) is widely prescribed for autoimmune and dermatologic conditions.
- Known ocular side effects of HCQ include retinopathy, corneal deposits, and choroidal thinning.
- Hyperpigmentation is a recognized, though less common, adverse drug reaction.
Observation:
- A case report details a 75-year-old female experiencing gradual, painless blue-gray hyperpigmentation.
- The discoloration affected the sclera, fingernails, and lower extremities after 10 months of HCQ therapy.
- This represents the first documented instance of HCQ-induced scleral hyperpigmentation.
Findings:
- Discontinuation of HCQ therapy resulted in partial reversal of the hyperpigmentation within 5 months.
- This clinical course strongly suggests HCQ as the causative agent for the observed hyperpigmentation.
- The findings highlight a novel manifestation of HCQ adverse drug reactions.
Implications:
- Increased awareness of HCQ-induced hyperpigmentation is crucial for clinicians.
- Recognizing this side effect can prevent patient distress and improve medication adherence.
- Further research into the mechanisms and prevalence of HCQ-induced hyperpigmentation is warranted.
Related Concept Videos
01:14Changes in Skin Color: Clinical Perspectives
The first thing a clinician sees is the skin, so the examination of the skin should be part of any thorough physical examination. Most skin disorders are relatively benign, but a few, including melanomas, can be fatal if untreated. A couple of the more noticeable disorders, albinism and vitiligo, affect the appearance of the skin and its accessory organs.
Albinism
Albinism is a genetic disorder that affects (completely or partially) the coloring of skin, hair, and eyes. The defect is primarily...
Albinism
Albinism is a genetic disorder that affects (completely or partially) the coloring of skin, hair, and eyes. The defect is primarily...
01:23Skin Diseases and Disorders
Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...
01:25Jaundice
Jaundice, or icterus, is the yellow discoloration of the skin, sclerae, and mucous membranes. It happens when plasma bilirubin levels rise above 2.5-3 mg/dL, leading to bilirubin deposition in tissue.Bilirubin is a byproduct of hemoglobin degradation. In macrophages, hemoglobin breaks down into globin and heme. Globin is converted into amino acids, while heme is turned into biliverdin by heme oxygenase, which is then reduced to unconjugated bilirubin by biliverdin reductase.Unconjugated...