Reactions 923 - 12 Oct 2002

Imipramine

Skin pigmentation in an elderly patient: case reportA 72-year-old woman developed pigmentation of her skin

during long-term treatment with imipramine [therapeuticindication not stated].

The woman had been receiving imipramine [dosage notstated] for approximately 30 years when she presented with an8-year history of progressively worsening slate-greypigmentation of her face and the extensor surface of herforearms that was photodistributed; her concomitantmedication included ranitidine and anacin. Upon examination,relative sparing of the skin folds, mucous membranes, sclerae,teeth and nails was noted. Histological examination of skinbiopsy specimens revealed collections of round to ovoid,yellow-brown globular deposits in the upper and mid dermis.The deposits were within macrophages and free within thedermis, and stained for melanin with a Fontana-Masson stain.[Patient outcome not stated.]

Author comment: ‘Because imipramine’s chemicalstructure is similar to chlorpromazine and its active metaboliteis desipramine, it is possible that imipramine producescutaneous hyperpigmentation through similar mechanisms,including abnormal melanogenesis and drug metabolitedeposition.’Angel TA, et al. Photodistributed blue-gray pigmentation of the skin associatedwith long-term imipramine use. International Journal of Dermatology 41: 327-329,Jun 2002 - USA 807210577

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Reactions 12 Oct 2002 No. 9230114-9954/10/0923-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved