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March 1989

Blue-Gray Discoloration of the Face

Author Affiliations

University of Miami (Fla) School of Medicine

Arch Dermatol. 1989;125(3):417-418. doi:10.1001/archderm.1989.01670150107019

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

DIAGNOSIS:  Amiodarone-induced cutaneous hyperpigmentation.

HISTOPATHOLOGIC FINDINGS  The hematoxylin-eosin-stained sections showed collections of yellow-brown granular pigment within histiocytes, predominantly perivascular throughout the

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