Amiodarone
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Amiodarone Hyperpigmentation: 3 case reports Three men developed hyperpigmentation during treatment with amiodarone. A 50-year-old man, who had been receiving amiodarone [Cordarone] 200-400 mg/day since July 2004 for atrial fibrillation and flutter, developed a progressive slate-gray skin discolouration in 2007 involving his face, ears and neck. Papules, consistent with rosacea, and hypertrophic sebaceous glands were also noted. Bilateral phase II cornea verticillata was confirmed on eye examination. Amiodarone was withdrawn gradually in February 2008, and his hyperpigmentation regressed slightly in the following months. A 61-year-old man, who had commenced amiodarone [Amiokordin] 400 mg/day in 2003 for myocardial ischaemia with tachyarrhythmia, developed a slate-gray skin discolouration on his face, neck and ears 2 years later. In March 2008, his hyperpigmentation worsened and, in April 2008, amiodarone was withdrawn. About 2 months later, his hyperpigmentation had improved slightly. A 70-year-old man, who had started amiodarone [Cordarone] 200 mg/day in 2004 for paroxymal atrial fibrillation, developed hyperpigmentation in April 2006, affecting his face, dorsal hands and forearms. He had a history of facial erythema since youth, that worsened with sun exposure. Following investigations, he was diagnosed with hyperpigmentation due to amiodarone in October 2007. Drug withdrawal and rosacea treatment were recommended, but he did not present for follow-up [patient outcome not stated]. Author comment: The pathogenesis of hyperpigmentation caused by amiodarone has not been entirely explained. It is presumed that the mechanism involves the acceleration of normal phagocytosis of drug deposits by macrophages in the dermis. Zgazarova S, et al. Skin adverse effects of amiodarone. Vnitrni lekarstvi 55: 976-980, No. 10, 2009 [Czech; summarised from a transaltion] - Czech 803015246 Republic
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Reactions 22 May 2010 No. 1302
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