One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine (Plaquenil), a chloroquine derivative. It is used to treat many diseases including malaria, rheumatoid arthritis and systemic lupus erythematosus. 5 year plaquenil protocol Hydroxychloroquine 200mg tablets cost Conclusions HCQ-induced pigmentation is considered uncommon adverse effect of HCQ, with a prevalence rate of 49.2% indicated in this study. Furthermore, history of bruising, sun exposure, and the presence of mucous membrane pigmentation are possible predisposing factors. The patient was diagnosed with granuloma annulare GA and started on hydroxychloroquine HCQ 300 mg daily. After 4 months of treatment, she developed bluish grey pigmentation within the plaques of GA with normal surrounding skin figure 1A,B. There was no pigmentation at other body sites. 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. It is imperative that patients and physicians are aware of and watch for this drug’s ocular side effects. Retinal toxicity from hydroxychloroquine is rare, but even if the medication is discontinued, vision loss may be irreversible and may continue to progress. Plaquenil induced hyperpigmentation Systemic Scleroderma Skin Involvement Hyperpigmentation and., Hydroxychloroquine induced cutaneous pigmentation a unique. Lupus alternatives to plaquenilPlaquenil and eyes side effects This skin hyperpigmentation was identified as an hydroxychloroquine adverse effect based on ongoing exposure and the drug was suspended; unfortunately it was not possible to see an improvement due to early death of the patient. Woman in grey hydroxychloroquine-induced hyperpigmentation. Persistent cutaneous hyperpigmentation due to hydroxychloroquinone one.. Drug-Induced Hyperpigmentation Review and Case Series American Board.. 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. Our data support the hypothesis that hydroxychloroquine-induced pigmentation is secondary to ecchymosis or bruising. Note This document contains side effect information about hydroxychloroquine. Some of the dosage forms listed on this page may not apply to the brand name Plaquenil. For the Consumer. Applies to hydroxychloroquine oral tablet. Along with its needed effects, hydroxychloroquine the active ingredient contained in Plaquenil may cause some. HCQ is often prescribed for longer durations and may be associated with cutaneous adverse effects such as yellow-brown or slate-grey pigmentation, bleaching of hair, exacerbation of pre-existing psoriasis, cutaneous rashes and pruritus.1 Cutaneous pigmentation occurs in 10%–30% patients, most commonly over shins, face and palate after approximately 4 months of receiving HCQ.2 The histopathology of HCQ-induced pigmentation consists of yellow-brown granules within macrophages and in the.