title: Diltiazem-induced hyperpigmentation.
abstract: A healthy-appearing 66-year-old black woman presented with a 5-year history of facial hyperpigmentation that was unresponsive to topical sunscreen, hydroquinone, tretinoin, and azelaic acid. Her medications included extended-release diltiazem for hypertension for the past 7 years, rofecoxib for arthritis, and pantoprazole for esophagitis. On examination, the woman displayed hyperpigmented patches and papules involving most of her face. The punch biopsy findings from a hyperpigmented papule on the right temple revealed compact hyperkeratosis, follicular dilation, and dense inflammatory infiltrate along the dermal-epidermal junction with abundant dying keratinocytes. Her diltiazem therapy was discontinued, which led to gradual resolution of her hyperpigmentation.
authors.affiliation: Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock 72205, USA.
authors.forename: Tracy
authors.initials: T
authors.lastname: Kuykendall-Ivy
authors.forename: Susannah Lambird
authors.initials: SL
authors.lastname: Collier
authors.forename: Sandra Marchese
authors.initials: SM
authors.lastname: Johnson
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003692:Delayed-Action Preparations / Q000009:adverse effects; D004110:Diltiazem / Q000008:administration & dosage / Q000009:adverse effects*; D005148:Facial Dermatoses / Q000139:chemically induced*; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced* / Q000473:pathology
chemical_list: D000959:Antihypertensive Agents; D003692:Delayed-Action Preparations; D004110:Diltiazem