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Photodistributed Hyperpigmentation in a Chronic Kratom User: Histologic and Elemental Characterization.

Aubrey Nicole Montebello1, Michael R Lewin-Smith2, Liesl Grenier3

  • 1SAUSHEC, Wilford Hall Ambulatory Surgical Center, Lackland, Texas, USA.

Journal of Cutaneous Pathology
|May 11, 2026
PubMed
Summary

Chronic kratom use can cause unusual skin discoloration, specifically photodistributed dyspigmentation. This case highlights a rare cutaneous side effect of kratom, involving pigment analysis.

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Pigmentation01:19

Pigmentation

The color of the skin is influenced by a number of pigments, including melanin, carotene, and hemoglobin. Recall that melanin is produced by cells called melanocytes, which are found scattered throughout the stratum basale of the epidermis. The melanin is transferred to the keratinocytes via melanosomes.
Melanin occurs in two primary forms: eumelanin that provides black and brown pigment and pheomelanin that provides red color. Dark-skinned individuals produce more melanin than those with pale...