Abstract
Drug-induced pigmentation occurs in up to 20% of acquired pigmentary disorders of the skin. Association of its occurrence was reported in certain drugs, including alkylating/cytotoxic agents, analgesics, antiarrhythmics, anticoagulants, antiepileptics, antimalarials, antimicrobials, antiretrovirals, metals, prostaglandin analogs, and psychotropic agents, among others. Proposed mechanisms include (1) accumulation of melanin, (2) accumulation of drug, (3) generation of new pigment, and (4) deposition of iron. Though difficult to confirm the drug association, the history, with emphasis on currently used drugs, and clinical examination may guide practitioners to an accurate diagnosis. Treatment options include cessation of the drug, adequate sun protection, and non-ablative pigment lasers.