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Eltrombopag-Associated Hyperpigmentation

Inbal Braunstein, MD1; Karolyn A. Wanat, MD1; Rosalie Elenitsas, MD1,2; XiaoWei Xu, MD, PhD1,2; Noelle Frey, MD3; Misha Rosenbach, MD1
[+] Author Affiliations
1Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
2Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia
3Department of Hematology and Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
JAMA Dermatol. 2013;149(9):1112-1115. doi:10.1001/jamadermatol.2013.5107.
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We report 2 cases of cutaneous hyperpigmentation with eltrombopag, a novel thrombopoietin receptor agonist.

Article InformationCorresponding Author: Inbal Braunstein, MD, 3600 Spruce St, 2 Maloney, Hospital of the University of Pennsylvania, Philadelphia, PA 19103 (inbal.braunstein@gmail.com).

Published Online: July 24, 2013. doi:10.1001/jamadermatol.2013.5107.

Conflict of Interest Disclosures: None reported.

Additional Contributions: We are indebted to Katie Dawson, MD, and the team from GlaxoSmithKline for helpful comments.

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Figure 1.
Images From Case 1

A, Clinical photograph of patient 1 demonstrates subtle gray discoloration of the face compared with the patient’s hands. B, Histopathologic image demonstrates brown granules of pigmentation (hematoxylin-eosin, original magnification ×600). C and D, This pigment was highlighted by Fontana-Masson stain (C) (original magnification ×600) and stained weakly positive with Prussian blue (D) (original magnification ×600).

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Figure 2.
Histopathologic Images From Case 2 With Diffuse Pigment Deposition

A, Low magnification demonstrates pigmentation throughout the dermis and in superficial subcutaneous tissue (hematoxylin-eosin, original magnification ×40). B-D, Higher magnification shows multiple foci of brown fine granules (B) (hematoxylin-eosin, original magnification ×600) that stain strongly positive with Fontana-Masson (C) (original magnification ×600) and Prussian blue (original magnification ×600).

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Eltrombopag-associated hyperpigmentation. JAMA Dermatol 2013;149(9):1112-5.
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