title: Imipramine-induced hyperpigmentation: a case report and review of the literature.
abstract: Imipramine-induced hyperpigmentation is rare with only 13 cases reported in the literature to date. We report a 64-year-old female who presented with blue-gray discoloration on her face present for 4-5 years. The patient's medications included imipramine for depression for approximately 23 years. Physical examination revealed slate-gray hyperpigmented discrete and coalescing macules of the malar cheeks and the bilateral temples and periorbitally. She also had diffuse gray pigmentation of the bilateral dorsal hands. Histologic examination revealed an unremarkable epidermis with golden-brown round globules clustered in the superficial dermis, which stained strongly positive with a Fontana-Masson stain. Prussian blue stain for hemosiderin was negative. A diagnosis of imipramine-induced hyperpigmentation was made. Imipramine-induced hyperpigmentation as well as a detailed review of drug-induced hyperpigmentation is discussed.
authors.affiliation: Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA. mark_dagostino@brown.edu
authors.forename: Mark L
authors.initials: ML
authors.lastname: D'Agostino
authors.forename: Jessica
authors.initials: J
authors.lastname: Risser
authors.forename: Leslie
authors.initials: L
authors.lastname: Robinson-Bostom
mesh_terms: D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage / Q000009:adverse effects*; D020405:Dermis / Q000473:pathology; D005260:Female; D006801:Humans; D007099:Imipramine / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D010859:Pigmentation Disorders / Q000139:chemically induced* / Q000473:pathology*; D013997:Time Factors
chemical_list: D000929:Antidepressive Agents, Tricyclic; D007099:Imipramine