Hydroxychloroquine-Induced Hyperpigmentation: A Case Report

Antimalarial agents, including chloroquine and hydroxychloroquine, have been used for the treatment of various rheumatoid diseases and skin diseases because of their anti-inflammatory and immune-modulating properties. Cutaneous adverse effects such as exacerbation of psoriasis, pruritus, and hyperpigmentation have been reported as side-effects of antimalarial drugs. In this case, we report a middle-aged man with a history of rheumatoid arthritis who was treated with non-steroidal anti-inflammatory drugs and hydroxychloroquine. He complained of hyperpigmentation of the face after one year of initiating the hydroxychloroquine. It was discontinued and methotrexate was started. Skin biopsy was confirmed drug reaction. After more than 10 years of follow up, his skin discoloration had not been improved.