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Drug- and heavy metal--induced hyperpigmentation
Journal of the American Academy of Dermatology
|July 1, 1981
Summary
Various drugs cause skin pigmentation changes through different mechanisms. Some deposit pigment directly, while others increase melanin production or alter skin structures, affecting cutaneous pigmentation.
Area of Science:
- Dermatology
- Pharmacology
- Toxicology
Background:
- Chemical and pharmacologic agents can induce alterations in cutaneous pigmentation.
- The precise mechanisms underlying these pigmentary changes are diverse and not fully elucidated for all agents.
Purpose of the Study:
- To review the mechanisms by which different classes of drugs cause changes in skin pigmentation.
- To differentiate the sites and nature of pigment alteration induced by various agents.
Main Methods:
- Literature review of studies on drug-induced pigmentation.
- Analysis of proposed mechanisms for hyperpigmentation and hypopigmentation.
- Categorization of agents based on their pigmentary effects.
Main Results:
- Fixed drug eruptions involve basement membrane alteration and pigment incontinence.
- Heavy metals cause pigmentation via particle deposition and increased melanin production.
- Antimalarials may bind to melanin; phenothiazines and minocycline involve drug deposition.
- Antineoplastic agents' pigmentary mechanisms are unclear, likely epidermal.
- Clofazimine causes pigmentation through deposition in subcutaneous fat.
Conclusions:
- Drug-induced skin pigmentation is a complex phenomenon with varied mechanisms.
- Understanding these mechanisms is crucial for diagnosis and management of pigmentary side effects.