Amiodarone hyperpigmentation T78.9

Amiodarone (Amiodarex®, Amiohexal®, Cordarex®, Tachydarone®), an iodinated benzofuran derivative, is a potassium antagonist used as a class III antiarrhthmic agent, particularly for supraventricular and ventricular tachycardia. Dermatologic UAWs include slate-gray dyschromias on light-exposed skin areas.

0.5-10% of patients treated with amiodarone show dose-dependent discoloration. 0.1-0.3% of patients develop full vision.

Usually long latency period of at least 10-12 months between first use of amiodarone and appearance of initial symptoms. Initial erythema in about 30-40% of patients, especially on the face. Later, blue or gray dyschromia in light-exposed areas. Skin folds and furrows are usually excluded.

Plaque-like perivascular agglomerates of yellow-brown colour complexes (lipofuscin) in the upper dermis. The "degeneration pigment" lipofuscin, a protein and cholesterol-containing mixture of lipo- and argentophilic pigments and is absorbed by lyosomes and histiocytes. Extracellular pigment does not occur.

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