Levofloxacin-Induced Acute Hyperpigmentation Changes in a Chronic Kidney Disease Patient

Medication-induced cutaneous hyperpigmentation has variable clinical presentations and is dependent on the specific drug involved. Most commonly, an attentive patient observes such changes early in the course; when missed by the patient, such changes are usually noted by an observant clinician. Clin...

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Main Authors: Shakuntala S. Patil, Sachin M. Patil, Ryan Campbell, Manisha Singh, Matthew Plotkin
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2020/6186471
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author Shakuntala S. Patil
Sachin M. Patil
Ryan Campbell
Manisha Singh
Matthew Plotkin
author_facet Shakuntala S. Patil
Sachin M. Patil
Ryan Campbell
Manisha Singh
Matthew Plotkin
author_sort Shakuntala S. Patil
collection DOAJ
description Medication-induced cutaneous hyperpigmentation has variable clinical presentations and is dependent on the specific drug involved. Most commonly, an attentive patient observes such changes early in the course; when missed by the patient, such changes are usually noted by an observant clinician. Clinical diagnosis can be challenging if the patient is on multiple medications because other causes must be excluded. This condition occurs via multiple mechanisms. Frequently, the pigmentary change is reversible with discontinuation of the drug. Causative medications include nonsteroidal; anti-inflammatory agents, antimalarials, antibiotics, psychotropics, amiodarone, and chemotherapeutic agents. The; antimicrobials responsible for hyperpigmentation are antimalarials, tetracyclines, tigecycline, dapsone, rifampicin, and antiretrovirals such as zidovudine. Sunlight exposure can worsen the pigmentation seen with some of the above antimicrobials (e.g., dapsone). Here, we describe an older adult white woman presenting with acute cutaneous; hyperpigmentation of the bilateral lower extremities while on levofloxacin therapy. Hyperpigmentation resolved after cessation of the agent. Our case highlights this unique acute presentation after only a few days of oral levofloxacin.
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spelling doaj-art-ac74f2363ebb471798fc9a1184d884ac2025-02-03T05:52:34ZengWileyCase Reports in Medicine1687-96271687-96352020-01-01202010.1155/2020/61864716186471Levofloxacin-Induced Acute Hyperpigmentation Changes in a Chronic Kidney Disease PatientShakuntala S. Patil0Sachin M. Patil1Ryan Campbell2Manisha Singh3Matthew Plotkin4University of Missouri Hospital and Clinic, 1 Hospital Drive, Columbia, MO 65212, USAUniversity of Missouri Hospital and Clinic, 1 Hospital Drive, Columbia, MO 65212, USAUniversity of Missouri Hospital and Clinic, 1 Hospital Drive, Columbia, MO 65212, USAUniversity of Missouri Hospital and Clinic, 1 Hospital Drive, Columbia, MO 65212, USAUniversity of Missouri Hospital and Clinic, 1 Hospital Drive, Columbia, MO 65212, USAMedication-induced cutaneous hyperpigmentation has variable clinical presentations and is dependent on the specific drug involved. Most commonly, an attentive patient observes such changes early in the course; when missed by the patient, such changes are usually noted by an observant clinician. Clinical diagnosis can be challenging if the patient is on multiple medications because other causes must be excluded. This condition occurs via multiple mechanisms. Frequently, the pigmentary change is reversible with discontinuation of the drug. Causative medications include nonsteroidal; anti-inflammatory agents, antimalarials, antibiotics, psychotropics, amiodarone, and chemotherapeutic agents. The; antimicrobials responsible for hyperpigmentation are antimalarials, tetracyclines, tigecycline, dapsone, rifampicin, and antiretrovirals such as zidovudine. Sunlight exposure can worsen the pigmentation seen with some of the above antimicrobials (e.g., dapsone). Here, we describe an older adult white woman presenting with acute cutaneous; hyperpigmentation of the bilateral lower extremities while on levofloxacin therapy. Hyperpigmentation resolved after cessation of the agent. Our case highlights this unique acute presentation after only a few days of oral levofloxacin.http://dx.doi.org/10.1155/2020/6186471
spellingShingle Shakuntala S. Patil
Sachin M. Patil
Ryan Campbell
Manisha Singh
Matthew Plotkin
Levofloxacin-Induced Acute Hyperpigmentation Changes in a Chronic Kidney Disease Patient
Case Reports in Medicine
title Levofloxacin-Induced Acute Hyperpigmentation Changes in a Chronic Kidney Disease Patient
title_full Levofloxacin-Induced Acute Hyperpigmentation Changes in a Chronic Kidney Disease Patient
title_fullStr Levofloxacin-Induced Acute Hyperpigmentation Changes in a Chronic Kidney Disease Patient
title_full_unstemmed Levofloxacin-Induced Acute Hyperpigmentation Changes in a Chronic Kidney Disease Patient
title_short Levofloxacin-Induced Acute Hyperpigmentation Changes in a Chronic Kidney Disease Patient
title_sort levofloxacin induced acute hyperpigmentation changes in a chronic kidney disease patient
url http://dx.doi.org/10.1155/2020/6186471
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