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Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Online ISSN 1827-1820
Department Dermatology and Allergology Universitätsklinikum Gießen and Marburg, Standort Marburg, Marburg, Germany
INTRODUCTION: Part of aquired hyperpigmentations of the skin are interpreted as adverse effect of drugs. However, systematic studies are rare in the literature, predominantly case reports have been published. The present systematic review attempts to provide a contribution to the body of evidence for a causal relation.
EVIDENCE ACQUISITION: The reports on an association of hyperpigmentation and drugs from 1970 until April 2016 found in medline and embase were rated according to the SIGN grading system for clinical studies. The highest level of evidence for each compound is quoted in a table.
EVIDENCE SYNTHESIS: 352 evaluated publications consist predominantly on reports of single cases, only a small number of larger case series have been available. Case-control-studies and randomized controlled studies (RCT) have rarely been found. The level of evidence for a causal relation to hyperpigmentation is low for the major part of drugs as quoted in order to the ATC-DDD. A causal relation is likely only for prostaglandins, minocyclin, phenothiazine, nicotine, and antimalaria drugs.
CONCLUSIONS: There is only poor body of evidence for an induction of hyperpigmentation by drugs. In only a small number of drugs a causal relationship is likely.