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Photodistributed Hyperpigmentation Associated With COVID-19 Vaccination.

Rebecca Gibons, Tanner Harding, Erica Ginsburg

    Journal of Drugs in Dermatology : JDD
    |January 6, 2026
    PubMed
    Summary

    A case study highlights a potential link between COVID-19 vaccination and photodistributed hyperpigmentation. This rare side effect, characterized by increased melanin deposition, warrants further investigation and awareness among healthcare providers.

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    Area of Science:

    • Dermatology
    • Vaccinology
    • Toxicology

    Background:

    • Drug-induced hyperpigmentation is a known phenomenon, but its pathogenesis varies.
    • Classic medications linked to hyperpigmentation include tetracyclines, prostaglandins, nicotine, and antimalarials.
    • The COVID-19 vaccine has been associated with various cutaneous reactions, though hyperpigmentation is rarely reported.

    Purpose of the Study:

    • To report a case of photodistributed hyperpigmentation following COVID-19 vaccination.
    • To investigate the potential causal relationship between COVID-19 vaccination and hyperpigmentation.
    • To raise awareness of this rare potential adverse effect of vaccination.

    Main Methods:

    • A case report of a 70-year-old female with blue-grey hyperpigmentation.
    • Analysis of patient history, including COVID-19 vaccination timing and prior medication use.
    • Histopathological examination of a skin biopsy using Fontana-Masson and Prussian blue stains.
    • Comprehensive laboratory workup to exclude other causes.

    Main Results:

    • The patient developed diffuse, blue-grey, photodistributed hyperpigmentation.
    • Skin biopsy revealed increased melanin deposition, confirmed by positive Fontana-Masson stain and negative Prussian blue stain.
    • No other identifiable metabolic triggers or classic medications were implicated.

    Conclusions:

    • COVID-19 vaccination is a plausible, though not definitively proven, cause of the patient's hyperpigmentation.
    • The temporal association and exclusion of other causes support vaccination as a potential trigger.
    • This case underscores the importance of recognizing rare cutaneous reactions post-vaccination.