Microprobe analysis of chlorpromazine pigmentation

Benning, T. L.

doi:10.1001/archderm.124.10.1541

Cited by 9 publications

(2 citation statements)

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“…1 Benning et al proposed that the granules contained CPZ because energy-dispersive X-ray microanalysis (EDXA) revealed a strong peak for sulfur. 11 However, as discussed earlier, an abnormal deposition of pheomelanin could account for this finding. Sicari et al proposed that CPZ, when exposed to ultraviolet light, produces a free radical (7-OH-CPZ) which is purple in color.…”

Section: Discussionmentioning

confidence: 71%

Photodistributed blue‐gray pigmentation of the skin associated with long‐term imipramine use

2002

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A 72-year-old white woman presented with progressively increasing slate-gray pigmentation of the face and extensor aspect of the forearms, which she had been suffering from for 8 years. She had been taking imipramine for approximately 30 years. Her other medications included ranitidine and anacin. Physical examination revealed slate-gray hyperpigmentation of the skin photodistributed on the face (Figs 1, 2) and extensor aspects of the forearms. Relative sparing of the skin folds, mucous membranes, sclerae, teeth, and nails was noted. The remainder of the physical examination revealed no abnormalities. Skin biopsy specimens from the right cheek and right forearm were obtained. Histologic examination revealed collections of variably sized, round to ovoid, yellow-brown globular deposits in the upper and mid dermis (Fig. 2). The deposits were identified within macrophages and free within the dermis. The epidermis was unremarkable and free of deposits. The deposits stained for melanin with a Fontana-Masson stain, but did not stain for iron.

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Section: Discussionmentioning

confidence: 71%

Photodistributed blue‐gray pigmentation of the skin associated with long‐term imipramine use

2002

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“…Hyperpigmentation of the mucous membranes and the skin can be associated with systemic diseases (Addison's disease, hemochromatosis, hyperthyroidism, and Wilson's disease), exposure to heavy metals (gold, iron, and silver) [2,3], and ingestion of drugs (antibiotic, antimalarial, antineoplastic, anti-arrhythmic, and psychotropic medications) (Table 1) [1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Psychotropic drugs associated with cutaneous hyperpigmentation include amitriptyline, chlorpromazine, citalopram, desipramine, imipramine, mirtazapine, phenytoin, sertraline, and thioridazine (Table 2) [1,5,7,14,[22][23][24][25][26][27][28][29][30][31][32]. Amitriptyline-induced hyperpigmentation has been previously (Table 3) [33,34], albeit seldom, described in the literature.…”

Section: Discussionmentioning

confidence: 99%

Amitriptyline-induced cutaneous hyperpigmentation: case report and review of psychotropic drug-associated mucocutaneous hyperpigmentation

Eichenfield

Cohen²

2016

Dermatology Online Journal

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Background: Several drugs can be associated with hyperpigmentation of mucosa or skin. They include antibiotic, antimalarial, antineoplastic, and psychotropic medications.Purpose: To describe a 42-year-old woman with amitriptyline-associated photo-distributed hyperpigmentation and to review psychotropic drug-induced hyperpigmentation of the skin.Materials and Methods: The features of a woman with amitriptyline-induced hyperpigmentation are presented. Using PubMed, the following terms were searched and relevant citations were assessed and discussed for context: amitriptyline, chlorpromazine, citalopram, desipramine, drug-associated, drug-induced, Fontana Masson, hyperpigmentation, imipramine, melanin, melanophages, mirtazapine, phenytoin, psychotropic, sertraline, thioridazine, tricyclic antidepressant.Results: Photo-distributed hyperpigmentation on the upper back of a woman developed six and a half years after initiation of amitriptyline therapy. Biopsy of the affected area showed pigment-laden melanophages and intradermal melanin deposition.Conclusions: Psychotropic drugs associated with cutaneous hyperpigmentation include amitriptyline, chlorpromazine, citalopram, desipramine, imipramine, mirtazapine, phenytoin, sertraline, and thioridazine. The hyperpigmentation may initially appear many years after starting the medication. Pathology typically shows melanophages and melanin in the dermis. Fontana Masson stain confirms the presence of melanin; Perl stain for hemosiderin or iron is negative. Discontinuation of the drug may result in spontaneous improvement. Further studies are needed to better understand the role of Q-switched laser in treating drug-induced hyperpigmentation.

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Disorders of Skin Colour

Anstey

Dermatologist²

2010

Rook's Textbook of Dermatology

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Microprobe analysis of chlorpromazine pigmentation

Cited by 9 publications

References 0 publications

Photodistributed blue‐gray pigmentation of the skin associated with long‐term imipramine use

Photodistributed blue‐gray pigmentation of the skin associated with long‐term imipramine use

Amitriptyline-induced cutaneous hyperpigmentation: case report and review of psychotropic drug-associated mucocutaneous hyperpigmentation

Disorders of Skin Colour

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