Clomipramine Skin pigmentation: case report

A 60-year-old woman with a 7-year history of unipolar depression , developed slate gray, blue-black and purplish (pseudocyanotic) pigmentations on light-exposed areas of her face and hands during 8 months ' treatment with clomipramine 75-100 mg/day. The most affected areas were her cheeks, nose, chin and the backs of her hands. Punch biopsy revealed large amounts of melanin in the upper dermis, mononuclear infiltration around epidermal blood vessels and liquefective basal cell layer degeneration .

Clomipramine treatment was withdrawn and the pigmentation gradually faded , leaving a few patches of light brown facial pigmentation after 8 months.

The biopsy findings suggested that the pigmentation developed from a photosensitive reaction occurring during clomipramine therapy. Tunca Z. Tunca MI Dllsiz A Bayok 0, Hanncloglu M C lomipramlne'lnduced pseudocyanotlc pigmentation. American Journal of Psychiatry 146. 552·553, Apr 1989 ""'"