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Drug-Induced Pigmentation — SCE Dermatology MCQ

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HardDrug ReactionsDrug-Induced PigmentationSCE Dermatology

A 50-year-old woman on Hydroxychloroquine for SLE develops a blue-grey pigmentation of her shins and palate. What is the cause?

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Correct answer: DHydroxychloroquine-melanin complex deposition in the dermis

The best answer is “Hydroxychloroquine-melanin complex deposition in the dermis”. Systemic and topical dermatological medicines require indication-specific counselling and monitoring; isotretinoin commonly alters serum lipids and carries stringent pregnancy-prevention and mental-health safeguards. The alternatives “Haemosiderin from venous disease”, “Ochronosis, within an appropriate UK pathway”, “Iron deposition, after clinicopathological correlation”, “Tattoo pigment, after specialist assessment” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: MHRA isotretinoin safety measures: https://www.gov.uk/government/publications/isotretinoin-for-severe-acne-uses-and-effects