Diltiazem‐associated photodistributed hyperpigmentation: Report of two Japanese cases and published work review

Abstract

Scherschum et al. proposed diltiazem-associated photodistributed hyperpigmentation as a novel type of drug-induced photosensitive lichenoid eruption. The characteristic clinical features were slate-gray reticulated hyperpigmentation on sun-exposed areas, while lichenoid dermatitis with prominent pigmentary incontinence was noted histologically. Although the clinical and histological features were similar to those of lichen planus pigmentosus, the histological features did not show either compact hyperkeratosis or wedge-shaped hypergranulosis, which are typical histological features of lichen planus. We describe two Japanese cases of diltiazem-associated photodistributed hyperpigmentation, who were successfully treated with topical tacrolimus, and review the published work.

Hyperpigmentation Induced by Combination Therapy With Telmisartan‐Hydrochlorothiazide

“…Photodistributed hyperpigmentation associated with diltiazem has been described. [7][8][9] Erbagci and colleagues 10 reported oral mucosal and cutaneous hyperpigmentation associated with amlodipine.…”

Valproic Acid-Induced Hyperpigmentation

“…Drugs of several classes are associated with skin or mucous membrane pigmentation and include nonsteroidal anti-inflamatory drugs, antimalarials, amiodarone, antineoplasic agents, tetracyclines, heavy metals, clofazimine, oral contraceptives, psycotropic drugs, anticonvulsants such as hydantoin, phenytoin and barbiturates (18)(19)(20)(21)(22)(23)(24). Other drugs reported to induce skin hyperpigmentation are amiodarone and some antihypertensives such as diltiazem, telmisartan and amlodipine (25)(26)(27)(28)(29).…”

Photodermatoses in skin of colour

“…Photodistributed hyperpigmentation caused by diltiazem, most often the extended release formulation, while rare, has been reported primarily in patients with SOC. This is a rare side‐effect with only twenty cases reported . It has been seen most commonly in black females, but can also affect black males, Asians and Hispanics .…”