Published in:
01-12-2013 | Clinical Image
Diltiazem-Associated Hyperpigmentation
Published in: Journal of General Internal Medicine | Issue 12/2013
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A 59-year-old African American female presented with a one-year history of progressive skin darkening. Her only symptom was mild itching. Medications included diltiazem 180 mg daily (extended release), prescribed three years earlier. Examination revealed blue-gray reticular hyperpigmentation in a photodistributed pattern on the face, neck, “V of the chest,” and extensor forearms (Fig. 1a, b). Punch biopsy showed a predominantly lichenoid reaction with upper dermal melanophages.
Figure 1.
Blue-gray reticular hyperpigmentation on the face (a) and neck (b) at initial presentation (3 years after starting diltiazem). Lesions were not palpable.
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