Antimalarial cutaneous side effects: a study in 209 users

Skare, Thelma L.; Ribeiro, Camila Ferrari; Souza, Fernanda H. M.; Haendchen, Leticia; Jordão, Juliana Merheb

doi:10.3109/15569527.2010.521225

Cited by 41 publications

(43 citation statements)

References 8 publications

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“…Öte yandan hastamızın romatoid artrit tanısı ile uzun yıllar kullandığı hidroksiklorokin, deri, mukoza ve tırnaklarda pigmentasyon yaptığı bilinen bir ilaçtır. Bu ilacın pigmentasyon yapma sıklığı %33 gibi yüksek oranda bildirilmiştir 5 . Özellikle güneş gören deride siyah-mavi-gri gibi değişen renklerde yamalar sıktır.…”

Section: Discussionunclassified

Melanotic lupus erythematosus: A rare variant of discoid lupus erythematosus

Kaçar¹,

Özuğuz²,

Yavaş³

et al. 2015

TURKDERM

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Discoid lupus erythematosus (DLE) is characterized by atrophic patches with peripheral hyperpigmentation on sun-exposed skin areas. It rarely presents with diffuse hyperpigmented patches without erythema, adherent scales and atrophy on the face and neck. This presentation is called melanotic lupus erythematosus and it has rarely been reported in the literature. Other conditions that cause facial pigmentation, such as melasma, Riehl melanosis, lichen planus pigmentosus, and drug-related pigmentation should be considered in the differential diagnosis. We herein, report a 66-year-old male patient with diffuse blue-brown pigmentations on his face who was diagnosed as having melanotic lupus erythematosus based on the clinical, histopathological and immunofluoresence findings. Summary Özet GirişYüzde yerleşen ve akkiz hiperpigmentasyonla seyreden lezyonların ayırıcı tanısında melazma, solar, lentigo, çiller, Riehl melanozu, liken planus pigmentozus (LPP), ilaca bağlı hiperpigmentasyon, ekzojen okronoz, argirya, Ota nevüs, Hori nevüs, Becker nevüs, fiks ilaç erüpsiyonu, akantozis nigrikans ve diskoid lupus eritematozus (DLE) gibi hastalıklar düşünülmelidir 1 . Bunlar arasında DLE sıklıkla güneş gören bölgelerde ortaları atrofik kenarları hiperpigmente plaklar şeklinde görülür. Nadir olarak yüz ve boyunda eşlik eden eritem, yapışık skuam ya da atrofi olmadan diffüz hiperpigmente plaklar şeklinde ortaya çıkabilir 2,3 .

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Section: Discussionunclassified

Melanotic lupus erythematosus: A rare variant of discoid lupus erythematosus

Kaçar¹,

Özuğuz²,

Yavaş³

et al. 2015

TURKDERM

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“…Most commonly, its use can result in hyperpigmentation of the forehead, hard palate, forearms, and shins [2, 3]; it can also cause pigmentation that appears on the cheek mucosa and nails [6, 11]. The development of hydroxychloroquine-associated cutaneous dyschromia is not so rare and can present as black, blue-gray or blue discoloration in photodistributed areas or skin sites protected from the sun [6]. …”

Section: Discussionmentioning

confidence: 99%

“…Retrospective studies cite the incidence of drug-related hyperpigmentation from hydroxychloroquine to be as high as 33% of individuals [6]. …”

Section: Introductionmentioning

confidence: 99%

Hydroxychloroquine-Associated Hyperpigmentation Mimicking Elder Abuse

Cohen

2013

Dermatol Ther (Heidelb)

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BackgroundHydroxychloroquine may result in cutaneous dyschromia. Older individuals who are the victims of elder abuse can present with bruising and resolving ecchymoses.PurposeThe features of hydroxychloroquine-associated hyperpigmentation are described, the mucosal and skin manifestations of elder abuse are reviewed, and the mucocutaneous mimickers of elder abuse are summarized.Case ReportAn elderly woman being treated with hydroxychloroquine for systemic lupus erythematosus developed drug-associated black and blue pigmentation of her skin. The dyschromia was misinterpreted by her clinician as elder abuse and Adult Protective Services was notified. The family was eventually cleared of suspected elder abuse. A skin biopsy of the patient’s dyschromia confirmed the diagnosis of hydroxychloroquine-associated hyperpigmentation.ConclusionHyperpigmentation of skin, mucosa, and nails can be observed in patients treated with antimalarials, including hydroxychloroquine. Elder abuse is a significant and underreported problem in seniors. Cutaneous findings can aid in the discovery of physical abuse, sexual abuse, and self-neglect in elderly individuals. However, medication-associated effects, systemic conditions, and accidental external injuries can mimic elder abuse. Therefore, a complete medical history and appropriate laboratory evaluation, including skin biopsy, should be conducted when the diagnosis of elder abuse is suspected.

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“…Mucocutaneous hyperpigmentation because of antimalarial therapy has been reported since World War II 2 ; however, HCQ-associated hyperpigmentation seems to be less common than with other antimalarials such as chloroquine 3,4 . The onset of HCQ-associated hyperpigmentation …”

mentioning

confidence: 99%