Hydroxychloroquine-related skin discoloration

Coulombe, Jérôme; Boccara, O.

doi:10.1503/cmaj.150622

Cited by 21 publications

(23 citation statements)

References 5 publications

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“…However, different pigmentation patterns were described. 15,17 In the current study, skin pigmentations appeared after a median duration of HCQ treatment of 3 years with a median cumulative HCQ dose of 200. In comparison, Bahloul et al described HCQ-induced pigmentations after a median duration of HCQ treatment of 6.1 years with a median cumulative dose of 720 g. 13 However, Melikoglu et al presented a case of HCQ-induced skin pigmentations one year after starting the treatment 81 .…”

Section: Discussionmentioning

confidence: 55%

“…4 Additionally, Coulombe and Boccara reported cases of hydroxychloroquine associated hyperpigmentation where the skin discoloration was partially resolved four months after switching to chloroquine. 15 However, Morrison et al observed persistent hyperpigmentation one year after stopping the drug. 16 In contrast to this observation, Bahloul et al reported an improvement in pigmented lesions in 6 out of 22 patients with hydroxychloroquine-induced hyperpigmentation despite the maintenance of their daily dose of HCQ.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and risk factors of hyperpigmentation induced by hydroxychloroquine in lupus patients

Mleeh

2019

Int J Res Dermatol

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Background: Antimalarials including hydroxychloroquine (HCQ) have been used in the treatment of systemic lupus erythematosus (SLE) for more than 50 years. Few cases of hyperpigmentation attributed to HCQ have been reported in the literature from different geographical areas. However, no case reports or local studies from Saudi Arabia estimated the magnitude of HCQ adverse effect. This study aimed to estimate the prevalence of HCQ-induced hyperpigmentation and to investigate the possible risk factors related to this condition.Methods: This retrospective study was conducted at King Abdulaziz University Hospital. All SLE patients on HCQ treatment, aged 18 years or above who visited Rheumatology and Dermatology Clinics were included. Those with the previous history of hyperpigmentation before starting HCQ treatment, or on chloroquine or quinacrine therapy were excluded. Medical records from September 2005 until June 2016 were reviewed.Results: Out of 199 cases, 98 (49.2%) cases had hyperpigmentation, only 13 (13.3%) cases reported resolution. The main sites affected were the hands 46 (23.1%), followed by face 45 (22.6%), then feet 18 (9.0%), leg and whole body equally 12 (6.0%). There was a significant association between hyperpigmentation and receiving medications, history of ecchymosis, sun exposure, the presence of mucous membrane pigmentations (p<0.0001, p=0.012, p<0.0001, p=0.022 respectively).Conclusions: HCQ-induced pigmentation is considered uncommon adverse effect of HCQ, with a prevalence rate of 49.2% indicated in this study. Furthermore, history of bruising, sun exposure, and the presence of mucous membrane pigmentation are possible predisposing factors.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors of hyperpigmentation induced by hydroxychloroquine in lupus patients

Mleeh

2019

Int J Res Dermatol

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“…Hydroxychloroquine‐induced hyperpigmentation of the skin and mucosae has mainly been described in patients with systemic lupus erythematosus, affecting approximately 7% of cases . Discrete or diffuse areas of brown or blue‐grey discoloration are typical, often affecting the face, forearms and lower legs, with occasional involvement of the palate, gingiva and nails .…”

Section: Prescribing and Current Guidelinesmentioning

confidence: 99%

Hydroxychloroquine in dermatology: New perspectives on an old drug

et al. 2019

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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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Section: Descriptionmentioning

confidence: 99%

“…The long-term use of hydroxychloroquine in systemic lupus erythematosus treatment is associated with skin lesions in about 7%–29% of the patients 1 2. It usually involves the oral mucosa, shins, nails, forearms and anterior side of the legs 1 2. The time of onset ranges from few months to years after starting treatment, opposite to the ophthalmological adverse effects that are associated with duration and cumulative dose of hydroxychloroquine.…”

Section: Descriptionmentioning

confidence: 99%