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November 29, 1976

Quinacrine Ochronosis

Author Affiliations

San Francisco

JAMA. 1976;236(22):2491. doi:10.1001/jama.1976.03270230015013

To the Editor.—  In the article "Quinacrine Ochronosis and Rheumatoid Arthritis" by Egorin et al (236:385, 1976), the pigmentation noted in the patient reported was similar to that which we had noted1 in 25 patients treated with antimalarials. However, I object to the use of the term "ochronosis." Ochronosis denotes a bluishblack pigmentation of connective tissue in patients with alkaptonuria.2 The term was originated by Virchow3 to describe the grossly blue-black but microscopically yellow-brown (ochre) pigmentation of cartilage and other connective tissue found in a patient who died of a ruptured aneurism. There was no pigmentation of cartilage in the patient reported in the current article.Similarly, the authors' association of the term "ochronosis" with the pigmentation of melanomas, chlorpromazine therapy, and industrial contact with quinones seems unwarranted.Others4 have also used the term "ochronosis" in association with antimalarial pigmentation. I feel the usage is confusing