In many cases, once the offending drug has been stopped, fading of the lesions occurs. However, the pigmentation may last a long time or become permanent. Chloroquine and receptor mediated endocytosis How to bill for plaquenil visual field The few reports of bluish pigmentation with HCQ described resolution within a few months or did not specifiy the duration of pigmentation after discontinuation of the drug 4, 5, 6. Hydroxychloroquine is converted to an inactive metabolite in the liver and excreted in urine 25% in the active form and bile. Mechanism of Toxicity. The mechanism of hydroxychloroquine retinal toxicity has yet to be fully elucidated. Studies have shown that the drug affects the metabolism of retinal cells and also binds to melanin in the RPE, which could explain the persistent toxicity after discontinuation of the medication. Hydroxychloroquine-induced pigmentation lesions usually begin after a few months or years of treatment. When we compared our patients with the controls, we found no significant association with the duration of HCQ treatment or with the cumulative dose of HCQ. Download PDF Many systemic medications may cause retinal toxicity. Because many drugs that induce skin pigmentation also cause photosensitivity reactions, sun protection is usually recommended. Hydroxychloroquine-induced pigmentation Drug-associated hyperpigmentation of the oral mucosa report of four., Hydroxychloroquine-Induced Retinal Toxicity - American Academy of. Puedo beber alcohol si tomo plaquenil Hydroxychloroquine HCQ-associated hyperpigmentation is uncommon, with onset ranging from 3 months to 22 years following the initiation of therapy 1. A 32-year-old woman presented with a 1.5-year history of symmetric polyarthritis, positive rheumatoid factor. Hydroxychloroquine-induced Hyperpigmentation of the Skin.. Hydroxychloroquine-Induced Pigmentation in Patients With.. Hydroxychloroquine-induced pigmentation in two patients with.. Blue–grey pigmentation of the skin affects up to 25% of patients taking hydroxychloroquine, especially where there has been bruising. Transverse pigmented nail bands and mucosal pigmentation have also been reported. Rashes may occur in up to 10% of patients, most commonly morbilliform or psoriasiform. IMPORTANCE Hydroxychloroquine-induced pigmentation is not a rare adverse effect. Our data support the hypothesis that hydroxychloroquine-induced pigmentation is secondary to ecchymosis or bruising. On examination, a telltale sign of hydroxychloroquine toxicity is a bilateral change in the retinal pigment epithelium of the macula that gives the commonly described appearance of a bull’s-eye. This is a late finding, however, and too late for screening to be useful.