Element‐specific analysis of a hyperpigmentation caused by levofloxacin therapy

An unusual brownish patch on the back of a 74‐year‐old Caucasian man

“…One characteristic of extrafacial ADMs is the lack of regression without becoming malignant. Apart from congenital dermal melanocytosis, the various diagnoses of ADM include post-inflammatory hyperpigmenta-tion, melasma, melanoma, Riehl melanosis and drug-induced hyperpigmentation [4,[8][9][10]. All these diagnoses can be eliminated by histological analysis.…”

Levofloxacin-Induced Acute Hyperpigmentation Changes in a Chronic Kidney Disease Patient

“…Among the quinolones, few cases have been reported, and all were due to pefloxacin and levofloxacin. The levofloxacin tablet coating contains small quantities of iron oxide and hydroxide [ 3 ]. The mechanisms responsible for this hyperpigmentation include drug metabolite deposits, precipitation of intracellular iron chelate complexes within macrophages, and increased intracellular melanin production [ 4 , 6 , 8 ].…”

“…A review of the medical literature via PubMed revealed only four reported cases of levofloxacin-induced cutaneous hyperpigmentation—all confirmed by biopsy [ 2 – 5 ]. On review of these cases, three patients were on oral levofloxacin therapy for more than four weeks [ 2 , 3 , 5 ]. One case report mentioned the use of levofloxacin for only eleven days.…”

Ungewöhnlicher bräunlicher Fleck auf dem Rücken eines 74‐jährigen Mannes kaukasischer Abstammung

“…Eine typische Eigenschaft der extrafazialen erworbenen dermalen Melanozytose ist, dass sie nicht mehr zurückbildet, ohne jedoch maligne zu entarten. Neben der angeborenen dermalen Melanozytose kommen weitere Differenzialdiagnosen in Betracht: post-inflammatorische Hyperpigmentierung, Melasma, Melanom, Riehl-Melanose und medikamenteninduzierte Hyperpigmentierung [4,[8][9][10]. Alle diese Diagnosen lassen sich durch eine histologische Untersuchung ausschließen.…”