title: Dose-dependent appearance and disappearance of amiodarone-induced skin pigmentation.
abstract: A 66-year-old man suffering from atrial flutter developed cutaneous blue-gray pigmentation while receiving 600 mg of amiodarone daily for 15 months. With reduction of the dose to 100 mg, skin discoloration disappeared within 16 months, to reappear within 7 months after increasing the dose to 400 mg. Finally, the discoloration disappeared within 13 months with a dose reduction to 200 mg daily. It seems that a tissue threshold level for amiodarone exists in this patient, above which skin discoloration appears and below which it fades. Dose, duration, metabolism, macrophage transfer, and spillover saturation-excretion may be relevant in amiodarone-induced skin pigmentation.
authors.affiliation: Department of Medicine Agios Andreas General Hospital, Patras, Greece.
authors.forename: N G
authors.initials: NG
authors.lastname: Kounis
authors.forename: C
authors.initials: C
authors.lastname: Frangides
authors.forename: P J
authors.initials: PJ
authors.lastname: Papadaki
authors.forename: G M
authors.initials: GM
authors.lastname: Zavras
authors.forename: J
authors.initials: J
authors.lastname: Goudevenos
mesh_terms: D000368:Aged; D000638:Amiodarone / Q000009:adverse effects* / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001282:Atrial Flutter / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008297:Male; D012871:Skin Diseases / Q000139:chemically induced*; D012880:Skin Pigmentation / Q000187:drug effects*
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone