Vinblastine-induced Acral Hyperpigmentation A 5-year-old girl, diagnosed with multi-system langerhans cell histiocytosis (bone, liver, bone marrow and pituitary involvement), was started on induction chemotherapy (weekly cycles of vinblastine/ prednisolone for 12 weeks). Two months later, she developed progressive bluish-black discolouration over the nose and fingertips along with darkening of the nail beds without any itching, pain, redness, numbness, trauma or sun exposure.
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