Drug induced changes in pigmentation

Levantine, Ashley; Almeyda, John

doi:10.1111/j.1365-2133.1973.tb01932.x

Cited by 49 publications

(16 citation statements)

References 37 publications

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“…Photosensitivity as a complication of MTX is uncommon, but it has been described in combination with ultraviolet phototherapy (11). In 1999 Toussirot & Wendung (12) described similar symptoms in a 40-year-old woman with rheumatoid arthritis following excessive sun-exposure and one year of MTX treatment (cumulative dose of 120 mg).…”

Section: Discussionmentioning

confidence: 97%

Hyperpigmentation of the Face Following Adalimumab Treatment

Blomberg¹,

Zachariae²,

Grønhøj³

2009

Acta Derm Venerol

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Sir.We report here a case of a patient with chronic psoriatic arthritis affecting multiple joints, in whom an unusual cutaneous reaction with hyperpigmentation of the face developed following treatment with adalimumab. CASE REPORTA 52-year-old man with a 17-year history of chronic psoriatic arthritis affecting multiple joints developed an unusual cutaneous reaction with hyperpigmentation of the face following treatment with adalimumab.Before treatment he had had only mild psoriasis of the skin., limited to a single lesion located behind one ear. For several years he had been treated with methotrexate (MTX) 12-15 mg weekly (cumulative dose approximately 12.000 mg) and ibuprofen 400 mg daily, but his arthritis deteriorated, resulting in a need for an alternative treatment. He did not have any other diseases and did not smoke tobacco. He had an average daily alcohol consumption of 8 units (1 U equals 33 cl of standard beer or 12 cl of non-fortified wine).At the beginning of April 2008 he commenced adalimumab 40 mg subcutaneously, every second week, concomitant with his stable dosage of MTX and ibuprofen. Following 2 weeks of adalimumab treatment there was no further need for analgesics, and ibuprofen was henceforward only taken when necessary, approximately twice monthly.In May 2008, 4-5 weeks after initiating adalimumab treatment, the patient was exposed to a considerable amount of sun during sun-bathing. He developed a reddish colour followed by a darker hyperpigmentation of the face, remarkably with a periorbital zone of apparently normal skin, even though he did not wear sunglasses (Fig. I ). His arms and legs were also heavily exposed to sunlight (not sunburned), but only the face was affected by hyperpigmentation. The patient experienced no other symptoms.The results of the following tests were either negative or within normal limits: haemoglobin, white blood cell count, se-creatinine, se-iron. alanine aminotransferase. lactate dehydrogenase. alkaline phosphatase, gamma-glutamyltransferase, platelets. C-reactive protein level, antinuclear antibodies, DNA-anti bod i es and urine porphyrins. Se-aspartate aminotransferase (ASAT) was increased to 74U/l(range 15-45 U/l). but later normalized without effect on the hypeipigmentation. Hislopathological examination of a 2 mm punch biopsy from the right chin revealed enlarged epidemial keratinocytes and hyperkeratosis as a result of earlier hydropic basal cell degeneration. Superficially in dermis there were many melanophages and a modest, mainly perivascular, lymphocytic infiltrate, consistent with post-inflammatory hyperpigmentation. The hyperpigmentaFig.

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Section: Discussionmentioning

confidence: 97%

Hyperpigmentation of the Face Following Adalimumab Treatment

Blomberg¹,

Zachariae²,

Grønhøj³

2009

Acta Derm Venerol

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“… 6 The accumulation of arsenic may also contribute to this hyperpigmentation, according to several authors. 7 Arsenical keratoses are the characteristic feature of chronic arsenic exposure. They consist of hyperkeratotic papules which usually are distributed symmetrically on the palms and soles, but may affect many other body sites.…”

Section: Discussionmentioning

confidence: 99%

Acute arsenic poisoning: clinical and histopathological features

Bartolomé¹,

Cordoba²,

Nieto

et al. 1999

Br J Dermatol

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We report a woman with acute arsenic poisoning, who developed an erythroderma with vesicles and pustules after the ingestion of 8-16 g of sodium arsenite. Simultaneously, she presented a herpes simplex virus infection. Skin biopsies showed unique features which included multiple small pigment granules inside and outside the histiocytes. In our opinion, these findings are consistent with acute arsenic poisoning, and constitute the first histological description of this entity in skin.

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“…Microscopic examination of the epi- Leukotrienes and thromboxanes may be responsible for the induction of postinflammatory hyperpigmentation dermis revealed increased melanogenesis and the presence of enlarged melanocytes. Certain antiepileptic agents (mainly hydantoins) may also cause skin hyperpigmentation (95). Their longterm use induces a brownish coloration of the face and neck, similar to chloasma of pregnancy.…”

Section: The Action Of Drugs Chemicals Etc On Human Skin Pigmentamentioning

confidence: 99%

Human skin pigmentation: melanocytes modulate skin color in response to stress

2007

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All organisms, from simple invertebrates to complex human beings, exist in different colors and patterns, which arise from the unique distribution of pigments throughout the body. Pigmentation is highly heritable, being regulated by genetic, environmental, and endocrine factors that modulate the amount, type, and distribution of melanins in the skin, hair, and eyes. In addition to its roles in camouflage, heat regulation, and cosmetic variation, melanin protects against UV radiation and thus is an important defense system in human skin against harmful factors. Being the largest organ of the body that is always under the influence of internal and external factors, the skin often reacts to those agents by modifying the constitutive pigmentation pattern. The focus of this review is to provide an updated overview of important physiological and biological factors that increase pigmentation and the mechanisms by which they do so. We consider endocrine factors that induce temporary (e.g., during pregnancy) or permanent (e.g., during aging) changes in skin color, environmental factors (e.g., UV), certain drugs, and chemical compounds, etc. Understanding the mechanisms by which different factors and compounds induce melanogenesis is of great interest pharmaceutically (as therapy for pigmentary diseases) and cosmeceutically (e.g., to design tanning products with potential to reduce skin cancer risk).

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Drug induced changes in pigmentation

Cited by 49 publications

References 37 publications

Hyperpigmentation of the Face Following Adalimumab Treatment

Hyperpigmentation of the Face Following Adalimumab Treatment

Acute arsenic poisoning: clinical and histopathological features

Human skin pigmentation: melanocytes modulate skin color in response to stress

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