REPORT OF A CASE
A 70-year-old man presented to the Dermatology Clinic at the University of Miami (Fla) Jackson Memorial Hospital with a chief complaint of enlarging blue-gray hyperpigmentation of his face. He had no history of a preceding rash or photosensitivity, and he denied using topical agents.The patient had a long-standing history of decompensated heart failure and cardiac arrhythmias refractory to quinidine, disopyramide phosphate, and procainamide.Physical examination revealed a blue-gray macular hyperpigmentation of the forehead, cheeks, and nose (Fig 1). No similar pigmentation was seen elsewhere on the body.A 3-mm punch biopsy specimen showed normal epidermis and a perivascular deposition of yellow-brown pigment within macrophages in the dermis (Fig 2).What is your diagnosis?Blue-Gray Discoloration of the Face
Amiodarone-induced cutaneous hyperpigmentation.
The hematoxylin-eosin-stained sections showed collections of yellow-brown granular pigment within histiocytes, predominantly perivascular throughout the
Klein AD, Pardo RJ, Gould E, Kerdel F. Blue-Gray Discoloration of the Face. Arch Dermatol. 1989;125(3):417-418. doi:10.1001/archderm.1989.01670150107019