Hydroxychloroquine-induced Hyperpigmentation of the Skin

Hydroxychloroquine (HCQ)-associated hyperpigmentation is uncommon, with onset ranging from 3 months to 22 years following the initiation of therapy1. A 32-year-old woman presented with a 1.5-year history of symmetric polyarthritis, positive rheumatoid factor, and anticyclic citrullinated peptide antibody, without erosive joint changes. She had presented shortly after a Cesarean birth complicated by wound dehiscence and infection. She was diagnosed with rheumatoid arthritis, and treatment was initiated with HCQ 200 mg twice …