Gardenia Fruit–Related Blue-Gray Skin Pigmentation

Gardenia fruit is widely used in herbal medicine, and it has choleretic, sedative, diuretic, anti-inflammatory, and antipyretic effects.¹ An ingredient of gardenia fruit is attracting attention as a possible cause of mesenteric phlebosclerosis, which is characterized by fibrotic change or calcification of the mesenteric vein and the bronze coloration of the colonic membrane.² Mesenteric phlebosclerosis may cause abdominal pain, stool abnormalities, and bowel obstruction, but it is often asymptomatic. It is suggested that genipin, a metabolite of geniposide (the major ingredient of gardenia fruit) is involved in the bronze coloration. Herein, we describe a patient who took the extract of gardenia fruit for 7 years, developed skin pigmentation complicated with mesenteric phlebosclerosis.