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