Observation |

Blue-Gray Pigmentation in Trunk and Extremities in a 71-Year-Old Man

Mónica Lorente, MD1; Adrián Ballano, MD1; Adriana Juanes, MD1; Maria Antonia Pastor, MD1; Jesús Cuevas, MD2
[+] Author Affiliations
1Department of Dermatology, Hospital Universitario de Guadalajara, Spain
2Department of Pathology, Hospital Universitario de Guadalajara, Spain
JAMA Dermatol. 2013;149(9):1111-1112. doi:10.1001/jamadermatol.2013.4365.
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Fluoroquinolones are a group of antibiotics widely used nowadays. Gastrointestinal and central nervous system symptoms are its most common adverse effects. Skin reactions are infrequent. We report herein a case of blue-gray pigmentation associated with levofloxacin.

Article InformationCorresponding Author: Mónica Lorente, MD, Donantes de Sangre s/n, E-19002 Guadalajara, Spain (m.lorente.luna@gmail.com; mlorentel@sescam.jccm.es).

Published Online: July 3, 2013. doi:10.1001/jamadermatol.2013.4365.

Conflict of Interest Disclosures: None reported.

Additional Contributions: Special thanks to Miguel Angel Martínez, MD, Hospital 12 de Octubre, Madrid, for ultrastructural study.

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Figure 1.
Blue-Gray Pigmentation in Clinical Images

A, Blue-gray pigmentation on the back of the hands and the extensor aspect of the forearms. B, Blue-gray pigmentation affecting the shins. C, Blue-gray pigmentation on the neck.

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Figure 2.
Histopathologic Findings

A, Black-brown deposits in the upper and deep dermis (hematoxylin-eosin, original magnification ×10). B, Panoramic view in which deposits are positively stained in superficial and deep layers (Perls stain, original magnification ×4). C, Interstitial and perivascular deposits positively stained with this argent technique (Masson-Fontana stain, original magnification ×40). D, Deposits corresponding to an exogenous material inside lysosomes of fibroblasts (ultrastructural study).

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