Hyperpigmentation From Chronic Kratom Use: A Case Report and Review of the Literature

Kratom, an opioid substitute derived from the leaves of Mitragyna speciosa, is commonly used for its opioid-like effects in East Asia and is gaining popularity in the United States. A rare side effect of chronic kratom use, previously noted in the literature, is skin hyperpigmentation. We present a unique case of diffuse, photodistributed hyperpigmentation in a patient with over a decade of kratom use. This case is accompanied by an evaluation of the adverse effect, focusing on its clinical presentation, histopathological findings, and potential mechanism. Additionally, we provide a brief literature review on the topic.