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.
[Med Arch 2025; 79(1.000): 67-70]

Hydroxychloroquine, Hyperpigmentation, Systemic lupus erythematosus, Drug side effect