Melasma: A rare adverse effect of clomipramine

Abstract

Melasma is a hyperpigmented dermatological condition common in females. Drugs such as steroids, cosmetics, and photosensitizing agents are known to cause melasma. We report here a case of an adult male with obsessive-compulsive disorder, receiving clomipramine, who developed melasma.

The effects of supramolecular nicotinamide combined with supramolecular salicylic acid on chloasma

“…In addition to ultraviolet exposure, pregnancy, endocrine disorders, race, family susceptibility and exogenous hormone stimulation, thyroid diseases, antidepressants, and trace element deficiency have also been reported. [5][6][7][8][9] It is generally believed that melasma is caused by complex interactions among epidermal melanocytes, dermal fibroblasts, keratinocytes and vascular endothelial cells, as well as by hormonal and genetic factors and UV exposure. 10 The etiology of melasma is complex and prone to relapse, and the treatment is relatively difficult, affecting the quality of life.…”

Melasma: A Condition of Asian Skin

“…The present review uncovered insufficient evidence of the effects of drugs such as clomipramine and imipramine on its correlation with the development of melasma as there are only two cases reported [ 27 , 28 ]. Additional research is warranted on the effects of clomipramine in particular on inducing melasma-like rashes in female patients.…”

“…Additionally, there have been small studies that have reported cosmetic products and drugs that bind to melanin pigments may also cause melasma development. A case study documenting a 35-year-old male taking clomipramine, a tricyclic anti-depressant for obsessive-compulsive disorder noted a development of hyperpigmented spots on the malar eminences of the face a few days after starting the medication and his facial hyperpigmentation disappeared after cessation of the drug [ 27 ]. Another case report of drug-induced hyperpigmentation is the use of the tyrosine-kinase inhibitor imatinib, an approved drug for the treatment of cancers such as chronic myeloid leukemia, metastatic GI tumors, and malignant melanoma.…”

Update on Melasma—Part II: Treatment

“…Finally, some cosmetics, photosensitizing drugs (e.g., phenothiazines, sulfonamides, sulfonylureas, thiazide diuretics, tetracyclines, tricyclic antidepressants, promethazine, piroxicam), and steroid hormones (e.g., contraceptive pills, estrogen replacement therapies) increase the melanogenic effect of sun exposure and should be substituted to enable successful melasma treatment [24][25][26][27]. Since melasma has a definitive genetic background, adoption of preventive measures such as sun protection and avoidance of contraceptive pills should be recommended in adolescent girls from families with melasma [28].…”