F1000Res 2018 6;7:284. Epub 2018 Mar 6.

Department of Dermatology, College of Medicine, King Faisal University, Hofuf, Saudi Arabia.

Dermoscopy, a non-invasive technique for cutaneous diagnosis is being increasingly studied in various disorders of the skin, nails and scalp. However, it has been under-utilized for the diagnosis and characterization of mucosal disorders. The dermoscopic characterization of cutaneous lichen planus and its variants has been well documented with Wickham's striae constituting the hallmark of the condition. Read More

Ann Afr Med 2018 Jan-Mar;17(1):40-42

Dermatology Unit, Department of Medicine, Barau Dikko Teaching Hospital, Kaduna, Nigeria.

Sparfloxacin, a synthetic, second generation, broad spectrum aminodifluoroquinolone antibiotic, has excellent penetration into respiratory tissues and has good activity against Gram-positive, Gram-negative, and atypical bacteria. Although it is indicated for the treatment of adult community-acquired pneumonia and acute exacerbation of chronic bronchitis, its use has been limited by phototoxicity which is more common with it than with other quinolones. We report a case of a 20-year-old Nigerian woman who developed a diffuse blue-black nail pigmentation of thumb and big toe nails, 2 weeks after completing therapy with sparfloxacin, and a recurrence of the pigmentation in the same nails 1 year after taking the drug again. Read More

Oral Surg Oral Med Oral Pathol Oral Radiol 2018 Mar 3;125(3):e54-e66. Epub 2017 Nov 3.

Department of Oral Medicine and Pathology, Faculty of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.

Objective: The aim of this study was to describe 4 patients with oral mucosa hyperpigmentation associated with 4 drug classes and to review the relevant literature.

Study Design: Two patients under imatinib and hydroxychloroquine treatment exhibited diffuse palatal hyperpigmentation and 2 patients treated with minocycline and golimumab showed multifocal pigmented macules. In all cases, biopsy was performed. Read More

Int J Dermatol 2018 Mar 20;57(3):332-338. Epub 2017 Dec 20.

Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Background: Short-term mucocutaneous adverse effects are well documented with imatinib. However, studies on long-term adverse effects and in the ethnic population are lacking.

Objective: To study the long-term mucocutaneous adverse effects of imatinib and factors predicting these adverse effects. Read More

Maxillofac Plast Reconstr Surg 2017 Dec 5;39(1):37. Epub 2017 Dec 5.

Maxillo-Facial and Dental Unit, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico, University of Milan, Via Commenda 10, 20122 Milan, Italy.

Background: Imatinib mesylate is an inhibitor of the tyrosine kinase Bcr-Abl and a first-line treatment for Philadelphia chromosome-positive chronic myeloid leukaemia (CML). Dermatological side effects include superficial oedema, pustular eruption, lichenoid reactions, erythroderma, and skin rash. Depigmentation of the skin and/or mucosa is uncommon, and hyperpigmentation is rare. Read More

Rev Med Brux 2017 ;38(5):439-441

Service de Gériatrie, Hôpital André Vésale, C.H.U. de Charleroi.

Fixed drug eruption is an erythematous eruption of one or more centimetric rounded or oval lesions well demarcated, recurrent at the same place and leaving a residual purple pigmentation. Diagnosis is clinical. Skin biopsy is not essential except in doubtful cases (eg bullous drug eruption can simulate Lyell Syndrome or mucosal reminiscent of erythema multiforme). Read More

Skin Appendage Disord 2017 Aug 22;3(3):161-162. Epub 2017 Apr 22.

Dermatology Division, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.

Respir Med Case Rep 2017 14;22:113-116. Epub 2017 Jul 14.

Geriatrics Department, Kaplan Medical Center, Affiliated with The Hebrew University of Jerusalem, Israel, Rehovot, Israel.

Ninety years old male was admitted to hospital due to breathlessness. The prominent findings were extensive blue-grey skin pigmentation and large left chylothorax. Drug induced lupus was diagnosed due to either minocycline chronic treatment or no alternative illness to explain his sub-acute disease. Read More

G Ital Dermatol Venereol 2017 Apr 19. Epub 2017 Apr 19.

Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy -

Melanocytes are found throughout the oral mucosa but usually go unnoticed because of their relatively low level of pigment production. When focally or generally active in pigment production or proliferation they may be responsible for several affections in the oral mucosae ranging from physiologic pigmentation, systemic diseases to malignant neoplasms. The diagnosis of oral pigmentations (OP) is usually challenging for the physician, but a careful examination of the oral cavity may reveal the first manifestation of underlying systemic diseases. Read More

Vet Dermatol 2017 Aug 6;28(4):400-e95. Epub 2017 Feb 6.

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, 220 Trowbridge Road, East Lansing, MI, 48824, USA.

Background: Drug-induced depigmentation is frequently observed in humans undergoing tyrosine kinase inhibitor therapy, whereas it is not reported in dogs. The skin depigmentation can occur after the first week of treatment and it is reversible within a few weeks after drug discontinuation.

Objectives: To report the clinical and histopathological features of an episode of cutaneous adverse drug reaction associated with short term administration of toceranib phosphate. Read More

Photodermatol Photoimmunol Photomed 2017 03 23;33(2):117-119. Epub 2017 Jan 23.

Department of Dermatology, Duke University Medical Center, Durham, NC, USA.

Br J Dermatol 2017 Apr 14;176(4):1021-1027. Epub 2016 Dec 14.

Dermatology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.

Background: The introduction of unclassified new psychoactive substances (NPS) on the recreational drugs market through open online sale ('legal highs' or 'Internet drugs') continues unabated and represents a growing health hazard. The use of NPS has resulted in numerous, severe, adverse events and fatalities, due to unintended overdose or unknown toxic side-effects.

Objectives: To try to find a possible common underlying cause for the skin-hair-eye symptoms complex observed in three men. Read More

JAAD Case Rep 2016 Jul 17;2(4):337-9. Epub 2016 Aug 17.

Department of Dermatology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio.

Eur J Dermatol 2016 Dec;26(6):531-536

Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy.

Hair colour modifications comprise lightening/greying, darkening, or even a complete hair colour change, which may involve the scalp and/or all body hair. Systemic medications may cause hair loss or hypertrichosis, while hair colour change is an uncommon adverse effect. The rapidly increasing use of new target therapies will make the observation of these side effects more frequent. Read More

Br J Dermatol 2017 Apr 28;176(4):902-909. Epub 2017 Feb 28.

Betsi Cadwaladr University Health Board, Ysbyty Gwynedd, Penrhosgarnedd, Bangor, Gwynedd, LL57 2PY, U.K.

Drug-induced photosensitivity occurs when a drug is capable of absorbing radiation from the sun (usually ultraviolet A) leading to chemical reactions that cause cellular damage (phototoxicity) or, more rarely, form photoallergens (photoallergy). The manifestation varies considerably in presentation and severity from mild pain to severe blistering. Despite screening strategies and guidelines in place to predict photoreactive drugs during development there are still new drugs coming onto the market that cause photosensitivity. Read More

J Ethnopharmacol 2016 Aug 2;190:272-87. Epub 2016 Jun 2.

Center of Bioinformatics, College of Life Science, Northwest A & F University, Yangling, Shaanxi 712100, China. Electronic address:

Ethnopharmacological Relevance: Vitiligo is a depigmentation disorder, which results in substantial cosmetic disfigurement and poses a detriment to patients' physical as well as mental. Now the molecular pathogenesis of vitiligo still remains unclear, which leads to a daunting challenge for vitiligo therapy in modern medicine. Herbal medicines, characterized by multi-compound and multi-target, have long been shown effective in treating vitiligo, but their molecular mechanisms of action also remain ambiguous. Read More

Ocul Oncol Pathol 2015 Jun 1;1(4):231-6. Epub 2015 Apr 1.

National Specialist Ophthalmic Pathology Service (NSOPS), Department of Histopathology, Royal Hallamshire Hospital, Sheffield, UK.

Purpose: To describe the clinical and histopathological features of a 61-year-old male with a history of eczema, asthma and schizophrenia on long-term chlorpromazine medication, who developed a unilateral limbal tumour in association with bilateral melanosis.

Procedures: The patient was referred for a routine cataract assessment, and an incidental pink gelatinous limbal lesion was detected on the left side, associated with bilateral speckled brown conjunctival pigmentation. The limbal lesion and brown pigmentation were biopsied. Read More

Cutan Ocul Toxicol 2017 Jun 10;36(2):135-139. Epub 2016 May 10.

b Department of Oncology , Ankara Numune Education and Research Hospital , Ankara , Turkey.

Background: Taxanes and anthracyclines are considered as fundamental drugs for the treatment of a broad range of cancers. They have several side effects, which may limit their usage. Drug-induced nail pigmentation (DHNP) has been reported as one of the most striking dermatological side effect of both taxanes and doxorubicin. Read More

Clin Case Rep 2016 Mar 8;4(3):276-8. Epub 2016 Feb 8.

Department for Pediatric Cardiology University of Leipzig - Heart Center Strümpellstr. 39 04289 Leipzig Germany.

Adverse effects of amiodarone are rarely seen in pediatric patients, but may occur if amiodarone is applied for long-term treatment. Two rather rare phenomena are blue-gray skin pigmentation and pulmonary mass. They represent important differential diagnoses from more common clinical complications like pneumonia and drug-induced toxic skin lesions. Read More

Cochrane Database Syst Rev 2015 Oct 26(10):CD007346. Epub 2015 Oct 26.

Department of Dermatology and Centre for Evidence-Based Medicine, Chang Gung Memorial Hospital, 6, Sec West, Chia-Pu Road, Puzih, Chiayi, Taiwan, 61363.

Background: Topical corticosteroids are the most frequently prescribed dermatological treatment and are often used by pregnant women with skin conditions. However, little is known about their safety in pregnancy.

Objectives: To assess the effects of topical corticosteroids on pregnancy outcomes in pregnant women. Read More

Dermatol Pract Concept 2015 Apr 30;5(2):79-81. Epub 2015 Apr 30.

Department of Clinical Medicine and Immunological Sciences, Dermatology Section, University of Siena, Siena, Italy.

We report the case of a 37-year-old woman (phototype II) who presented at our outpatient clinic with a two-month history of hyperpigmented plantar macules. Medical history revealed that the patient had taken capecitabine in the past three months as adjuvant chemotherapy for recurrent breast cancer. Dermoscopic examination of the plantar macules showed parallel ridge pattern with pigmentation in the furrows without obliteration of eccrine gland apertures. Read More

Rev Med Liege 2015 Apr;70(4):204-6

The melanotic facial pigmentation of each individual is frequently heterogeneous, even when this condition remains imperceptible under natural ambient light. However, with aging, this aspect may appear to everybody. The melanin heterochromia has various origins including ethnicity, the hormonal impact, the influence of various inflammatory, toxic and drug-induced disorders, as well as the impact of photoaging. Read More

J Drugs Dermatol 2015 Apr;14(4):411-4

Minocycline is among the most common drugs to cause drug-induced pigmentation. Dermal deposition of drug metabolites typically occurs in areas of vascular leakage, such as surrounding lower extremity spider veins, within erythema associated with solar elastosis, and in areas of bruising. The skin affected by minocycline pigmentation typically takes on a slate-gray coloring in affected areas. Read More

Pediatr Transplant 2014 Nov 25;18(7):E240-5. Epub 2014 Aug 25.

Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

Dapsone is a sulfone-type drug used widely for different infectious, immune, and hypersensitivity disorders as an antibacterial treatment alone or in combination for leprosy and sometimes for infected skin lesions. DHS is a severe idiosyncratic adverse reaction with multi-organ involvement. However, acute necrotic hepatitis requiring an emergent LT is rare. Read More

JAMA Dermatol 2014 Sep;150(9):984-9

Department of Dermatology, Beilinson Hospital, Rabin Medical Center, Petach Tiqva, Israel2Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Importance: Many drugs have been reported to induce skin and/or mucous membrane discoloration. Ezogabine (retigabine) was recently approved as an add-on drug for the treatment of partial seizures in adults with epilepsy. Mucocutaneous discoloration induced by antiepileptic drugs in general and ezogabine in particular has not been previously reported. Read More

JAMA Dermatol 2014 Feb;150(2):182-4

Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York.

IMPORTANCE Medications as well as chemical and food exposures have been causally linked to the development of pigmented purpuric dermatosis (PPD). We describe herein what is to our knowledge the first reported case of isotretinoin-induced PPD. OBSERVATIONS A woman in her 30s presented with purpura annularis telangiectodes of Majocchi on the lower extremities 2 months after initiating isotretinoin for the treatment of refractory nodulocystic acne. Read More

Clin Dermatol 2013 Sep-Oct;31(5):627-49

Chairman, Department of Dermatology, Herbert Wertheim College of Medicine, Florida International University; Director, Greater Miami Skin and Laser Center, Mount Sinai Medical Center, 4308 Alton Road, Suite 750, Miami Beach, FL 33140. Electronic address:

Nail abnormalities can arise in conjunction with or as a result of systematic pathologies. These pathologies include single-organ diseases, multisystemic diseases, and drug-induced insults. Clinical signs associated with these conditions include dyschromias, vascular alterations, periungual tissue changes, textural dystrophies, contour alterations, and growth-rate alterations. Read More

Ann Dermatol Venereol 2013 Mar 11;140(3):183-96. Epub 2013 Jan 11.

Dermatologie, centre de lutte contre le cancer, institut Claudius-Regaud, 20-24, rue du Pont-Saint-Pierre, 31052 Toulouse, France.

The occurrence of hyperpigmentation during chemotherapy is one of the most frequent dermatological adverse events observed with these drugs. It may arise with numerous anticancer agents, and can be either localized or diffuse, occurring either immediately or after inflammatory dermatological lesions. Nails, mucosa and skin may all be affected. Read More

Diabetes Ther 2012 Dec 6;3(1):14. Epub 2012 Nov 6.

Division of Diabetes, Clinical Nutrition and Endocrinology, Department of Internal Medicine, Kasai Electric Power Hospital, 2-1-7 Fukushima, Fukushima Ward, Osaka City, 553-0003, Japan.

A generalized skin eruption with strong itching was induced by sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, in a patient almost 6 months after initiation of the drug. Physical examination revealed a spread of skin rash from chest to back, and abdomen and thigh. Discontinuation of the drug eliminated the skin rash immediately. Read More

Hautarzt 2012 Sep;63(9):704-9

Univ. Klinik für Mund-, Kiefer- und Gesichtschirurgie, Paracelsus Medizinische Privatuniversität Salzburg, Müllner Hauptstr. 48, 5020, Salzburg, Österreich.

The oral mucosa contains melanocytes, even though one might not suspect this when examining white subjects. Drug-induced pigmentation is usually irregularly distributed over the oral mucosa; typical causes are contraceptives and tetracyclines. Localized traumatic pigmentation can be due to injuries contaminated by foreign material (dust). Read More

Toxicol Sci 2012 Jun 8;127(2):360-70. Epub 2012 Mar 8.

Department of Biomolecular Chemistry, University of Wisconsin, Madison,Wisconsin 53705, USA.

The embryos of teleost fish are exquisitely sensitive to the toxic effects of exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). However, several lines of evidence suggest that adults are less sensitive to TCDD. To better understand and characterize this difference between early life stage and adults, we exposed zebrafish (Danio rerio) to graded TCDD concentrations at different ages. Read More

Photodermatol Photoimmunol Photomed 2012 Feb;28(1):2-5

Institute of Dermatology, University of Pavia and Foundation IRCCS Policlinico S. Matteo, Pavia, Italy.

Background: Imatinib mesylate (IM) is a phenylaminopyrimidine that represents the first-line treatment for chronic myeloid leukemia (CML), Philadelphia chromosome-positive. It acts as a potent and selective inhibitor of the bcr-abl fusion protein by a competitive inhibition at the adenosine triphosphate-binding site of the enzyme, which leads to the inhibition of tyrosine phosphorylation of the proteins involved in bcr-abl signal transduction. IM is generally well tolerated and usually provokes only mild side effects consisting of nausea, myalgia, edema and muscle cramps. Read More

Photodermatol Photoimmunol Photomed 2011 Dec;27(6):328-30

Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan.

We report a 68-year-old Japanese man who developed photoleukomelanoderma following prolonged photosensitivity caused by hydrochlorothiazide. He showed complete recovery from the leukomelanoderma with the discontinuation of the responsive drug and with topical application of tacrolimus hydrate and corticosteroid. Histological and immunohistochemical examination revealed that there were no melanin-positive cells in the hypopigmented area, despite the presence of melanocytes. Read More

J Drugs Dermatol 2011 Nov;10(11):1316-9

Main Line Center for Laser Surgery, 32 Parking Plaza, Ardmore, PA 19003, USA.

A number of drugs can cause cutaneous hyperpigmentation through a variety of mechanisms. The pigment is comprised of dermal deposits of the drug and its metabolites, often combined with melanin and hemosiderin. Minocycline and amiodarone are among the most common medications to cause skin-induced pigmentation. Read More

Acta Derm Venereol 2012 Mar;92(2):220; author reply 220

Prescrire Int 2011 Sep;20(119):214

Minerva Stomatol 2011 Jun;60(6):327-32

Department of Stomatology and Oral and Maxillofacial Surgery, São Leopoldo Mandic Dental School Campinas, Brazil.

Antimalarial drugs, like chloroquine, may produce hyperpigmentation of the oral mucosa, affecting most commonly the palate. Its pathogenesis is not clear; an increased production of melanin is currently believed to be the cause of this oral manifestation. The purpose of this study was to report a case of atypical oral mucosal hyperpigmentation secondary to antimalarial therapy. Read More

Bull Environ Contam Toxicol 2011 Apr 15;86(4):389-93. Epub 2011 Mar 15.

Department of Pharmacology, Federal University of Paraná, Curitiba, PR, Brazil.

The toxic effects of water-soluble fraction (WSF) of crude oil (API27, Petrobras Campos Basin, Brazil) were evaluated during the early life stages of zebrafish, as well as its biotransformation in juvenile fish. Embryonic development was studied during 96 h. Reduced heartbeat rate, weak pigmentation, tail defects, and embryo mortality were observed for all of the tested concentrations of the WSF. Read More

J Dermatol 2011 Jan;38(1):41-4

Department of Dermatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

One of the recent advances in dermoscopy is the significance of parallel ridge pattern (PRP), which has 99% specificity in detecting both melanoma in situ and advanced melanoma on the acral volar skin. This review features exceptionally benign acral lesions showing PRP on dermoscopy. These benign lesions can be distinguished from malignant melanoma, because of the typical clinical history and associated symptoms. Read More

Eur J Dermatol 2010 Jul-Aug;20(4):461-4. Epub 2010 May 27.

Department of Dermatology, Bichat Hospital, APHP, 46 rue Henri-Huchard, 75877 Paris, France.

Fixed drug eruption (FDE) is one of the most typical cutaneous drug adverse reactions. This localized drug-induced reaction is characterized by its relapse at the same sites. Few large series of FDE are reported. Read More

J Coll Physicians Surg Pak 2010 Mar;20(3):154-7

Department of Dermatology, Liaquat University of Medical and Health Sciences, Jamshoro.

Objective: To evaluate the clinical characteristics, predisposing/aggravating factors and malignant potential of oral lichen planus (OLP).

Study Design: Case series.

Place And Duration Of Study: Department of Dermatology and Oral Pathology, Liaquat University Hospital, Hyderabad, from January 2006 to November 2007. Read More

Chemosphere 2010 Apr 3;79(5):529-33. Epub 2010 Mar 3.

Department of Environmental Science, East China Normal University, Shanghai 200062, China.

Tributyltin (TBT) has been widely used as a biocide in antifouling paints and is a known endocrine disrupting chemical. In this paper, we exposed embryos of Xenopus tropicalis to 50-400ngL(-1) tributyltin chloride. TBT significantly decreased the survival rate, reduced the body length and retarded the development of embryos after 24, 36 and 48h of exposure. Read More

Comp Biochem Physiol C Toxicol Pharmacol 2010 Jun 24;152(1):62-8. Epub 2010 Feb 24.

Department of Environmental Science, Key Laboratory of Urbanization and Ecological Restoration, East China Normal University, Shanghai 200062, China.

Tetrabromobisphenol A (TBBPA) is the most widely used brominated flame retardant and a known thyroid disruptor. We reported exposing Xenopus tropicalis embryos (NF10) to 0.01, 0. Read More

Ann Dermatol Venereol 2010 Jan 7;137(1):32-5. Epub 2009 Nov 7.

Université François-Rabelais, Tours, France.

Background: Hypercarotenaemia is the consequence of high serum carotenoid levels, which are deposited in the stratum corneum and give a yellowish coloration to the skin. It can be distinguished from jaundice by the absence of colouring of the conjunctivae as well as orange discolouration of the palms and soles.

Case Report: We report a rare case of hypercarotenaemia in a child that began at the age of three months. Read More

Dermatol Nurs 2009 Nov-Dec;21(6):327-8, 335

Dermatology Associates of Berkeley, Berkeley, CA, USA.

Prescrire Int 2009 Oct;18(103):208-11

(1) Photosensitivity reactions are cutaneous disorders due to exposure to ultraviolet (UV) radiation of natural or artificial origin. They occur or are more prevalent on unprotected skin. The main clinical manifestations are burns, eczema-like rash, urticaria, pigmentation, or onycholysis; (2) Many drugs increase cutaneous sensitivity to UV, sometimes for therapeutic purposes, but it is generally an unwanted effect. Read More

Ann Dermatol Venereol 2009 Aug-Sep;136(8-9):645-9. Epub 2009 Jul 21.

Service de dermatologie, hôpital Sainte-Marguerite, 270, avenue de Sainte-Marguerite, 13274 Marseille cedex 09, France.

The side effects of patch-tests are usually mild if testing is done properly, but they can interview with the test results and interpretation. The most troublesome complication is an indication by the test of active allergen-specific sensitization. The associated contraindications are dependent on the patient's status (immunodepression, pregnancy, ongoing eczema) and on the allergen in question (unknown, irritant, sensitizing). Read More

Australas J Dermatol 2009 Aug;50(3):214-6

Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey.

Drug-induced hair colour and texture changes have been reported rarely. We describe a 70-year-old woman with psoriasis who noticed darkening of her previously white hair, which also gained a curly appearance after 6 months of acitretin treatment. We present this case to emphasize that acitretin can be added to the list of drugs that induce changes in hair colour and texture. Read More

Cochrane Database Syst Rev 2009 Jul 8(3):CD007346. Epub 2009 Jul 8.

Department of Dermatology, Chang Gung Memorial Hospital-Chiayi, Chang Gung University College of Medicine, 6, Sec West, Chia-Pu Road, Putz, Chiayi, Taiwan, 61363.

Background: Topical corticosteroids are the most frequently prescribed dermatological treatment and are frequently used by pregnant women with skin conditions. However, little is known about their safety in pregnancy.

Objectives: To assess the effects of topical corticosteroids on pregnancy outcomes. Read More

J Cutan Pathol 2009 Jul;36(7):799-803

Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.

Imipramine-induced hyperpigmentation is rare with only 13 cases reported in the literature to date. We report a 64-year-old female who presented with blue-gray discoloration on her face present for 4-5 years. The patient's medications included imipramine for depression for approximately 23 years. Read More