Differential Diagnosis > Morphology > Color > Hyperpigmentation > Drug Induced Hyperpigmentation

Drug Induced Hyperpigmentation

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hmtoggle_plus1blue-gray hyperpigmentation:

       

amiodarone                
minocycline (esp. areas of previous inflammation)        
imipramine                
chlorpromazine        

photodistributed:

yes

no

yes

yes

 

antimalarials – soft and hard palate, pretibial, appears yellow        
zidovudine – especially nails        

 

chemotherapy:

bleomycin – flagellate streaks of hyperpigmentation        
FU – serpentine supravenous hyperpigmentation                
busulfan – diffuse bronze; ddx = addison’s                

 

 

melasma-like hyperpigmentation estrogen, phenytoin

 

 

Heavy-metal induced:

mercury (containing cosmetics);  especially skin folds;  not photodistributed
argyria photodistributed
arsenic “rain drops on a dusty road”; and macular bronze discoloration on trunk