Background: Hydroxychloroquine (HCQ) is an anti-malarial, antirheumatic disease-modifying medication. Besides the familiar adverse effects, HCQ has been associated with cutaneous manifestations like hyperpigmentation, vitiligo, and pruritus. Objective: This case report aims to describe the clinical features and outcome of hydroxychloroquine-induced skin hyperpigmentation in a patient with SLE. Case presentation: In this case report, we present a 32-year-old man with a history of Systemic lupus erythematosus who was treated with hydroxychloroquine. One year after treatment, the patient complained of diffused discoloration and melanonychia. Furthermore, punch biopsy from the involved sites showed pigment incontinence. To our knowledge, this is the only case reported with biopsy and photographic evidence from our geographical area. Conclusion: Hydroxychloroquine-induced pigmentation is not a rare adverse effect of HCQ. Biopsy revealed pigment incontinence. Additionally, our patient had no history of ecchymoses or anticoagulant therapy.
Key words: Hydroxychloroquine, Hyperpigmentation, Systemic lupus erythematosus, Drug side effect.
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