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November 2007

Blue-Black Pigmentation of Legs and Arms in a 68-Year-Old Woman—Quiz

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Copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2007

Arch Dermatol. 2007;143(11):1441-1446. doi:10.1001/archderm.143.11.1441-b

A 68-year-old white woman requested consultation for the progressive blue-black pigmentation of both legs during the past 4 months. Her personal medical history included right and left knee prostheses placed 2 and 4 years ago, respectively, before the present visit. Six months before coming to our department she had undergone a surgical operation to treat a fracture of her right femur. Subsequently, an infection of the right knee prosthesis developed. Treatment with 500 mg/d of oral levofloxacin was begun. One month into this treatment regimen, she started to notice a blue-black discoloration on the front side of the legs, which progressively extended through the thighs and dorsum of the legs and later to the forearms. The patient denied the external application of any product or the ingestion of other drugs. She had not been sunbathing. The results of blood and urine tests were normal.

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