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Drug-induced pigmentation in Adult
Other Resources UpToDate PubMed

Drug-induced pigmentation in Adult

Contributors: David O'Connell MD, William Schaffenburg MD, Catherine J. Wang, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Drug-induced pigmentation and/or hyperpigmentation may be caused by numerous drugs through a number of differing mechanisms. There may be a stimulation of increased melanin production or deposition of the drug or its metabolites in the epidermis and/or dermis. Perhaps the most common reaction is postinflammatory hyperpigmentation, as typically seen following inflammatory drug eruptions or fixed drug eruptions. A further mechanism of drug-induced pigmentation is the production of new pigment such as increased lipofuscin synthesis.

Increased melanin most often produces a brownish pigmentation in the dermis. When active compounds deposit in the dermis, however, there may be associated red-brown, blue-black, blue-gray, purple, or slate discoloration.

There are certain classes of drugs that are more commonly implicated in causing skin, mucous membrane, and nail pigmentation. These include antimalarials, some antimicrobials, heavy metals, antineoplastic (chemotherapeutic) agents, and psychotropics and anticonvulsants. NSAIDs and antiretrovirals have also been noted as causing specific pigment changes. Chronic use of kratom, an opioid-like supplement available over the counter, has been associated with photodistributed hyperpigmentation, often of the face and hands.

Related topics: drug-induced flagellate pigmentation, amiodarone drug-induced pigmentation, minocycline drug-induced pigmentation, drug-induced hypopigmentation, drug-induced oral pigmentation, drug-induced nail pigment, fixed drug eruption

Codes

ICD10CM:
L81.9 – Disorder of pigmentation, unspecified
T50.905A – Adverse effect of unspecified drugs, medicaments and biological substances, initial encounter

SNOMEDCT:
110284009 – Drug-induced pigmentation

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Last Reviewed:01/17/2023
Last Updated:06/30/2024
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Drug-induced pigmentation in Adult
A medical illustration showing key findings of Drug-induced pigmentation
Clinical image of Drug-induced pigmentation - imageId=152129. Click to open in gallery.  caption: 'Brown and violaceous macules and patches on the dorsal hands, developing secondary to medication.'
Brown and violaceous macules and patches on the dorsal hands, developing secondary to medication.
Copyright © 2024 VisualDx®. All rights reserved.