Hydroxychloroquine is an age-old drug whose use as an immunomodulatory agent with a low side-effect profile continues to expand. We present a review of this drug including recently updated prescribing recommendations and a summary of its clinical application in dermatology. A maximum daily dose of 5.0 mg/kg based on actual body weight and no greater than 400 mg is advised in order to reduce the risk of retinopathy, which is potentially permanent and has an estimated prevalence of 7.5% at 5 years on standard dosing. Baseline ophthalmologic assessment followed by annual screening after 5 years is recommended; however, closer monitoring should be considered in the setting of existing retinopathy, a cumulative dose > 1000 g or renal dysfunction. Hydroxychloroquine is now considered to be safe in pregnancy, and routine glucose-6-phosphate dehydrogenase (G6PD) deficiency testing is not required. Smoking can significantly decrease its efficacy although the reason is still uncertain. Hydroxychloroquine appears to also demonstrate antineoplastic and cardioprotective benefits.

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other cutaneous findings as adenoma sebaceum, periungual fibromas and ash-leaf macules. 3 Papular elastorrhexis can mimic eruptive collagenoma clinically. But histopathologically, fragmented elastic fibres are seen in papular elastorrhexis unlike eruptive collagenoma. Naevus anelasticus is an acquired naevus characterised by perifollicular papules and histopathologically findings with paucity or lack of elastic tissue, normal collagen. 5 Biopsy is needed to differentiate these conditions from eruptive collagenoma. No treatment is required, as for the condition is benign. 4