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Kratom-Induced Hyperpigmentation: An Emerging Clinicopathologic Pattern
Matthew H Friedland1, Steve Lu1, Margaret S Johnston2
1Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA.
None:
Kratom (Mitragyna speciosa) is a commonly used over-the-counter supplement with opioid-like and dopaminergic activity. Cutaneous side effects have been incompletely characterized; only limited case reports describe its associated hyperpigmentation. We describe two cases of kratom-induced photodistributed brown-gray patches with biopsies that show circular, orange-brown granules in the dermis that stain positive with Fontana-Masson and negative for iron. In conjunction with existing literature, our cases suggest a possible distinct clinicopathologic pattern for which kratom use can be suspected.
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