Case Report: Scleral hyperpigmentation associated with oral hydroxychloroquine use

Hydroxychloroquine (HCQ) is a commonly used medication for its immunosuppressive and dermatologic effects. It has known ocular side effects, which include retinopathy, corneal deposits, choroidal thinning. Herein, we report the first case of HCQ-induced hyperpigmentation sclera. A 75-year-old female presented after 10 months gradual progression painless blue-gray discoloration bilateral sclera, fingernails, lower extremities secondary to oral HCQ therapy. Cessation drug led partial reversal at 5 months, further supporting as causative agent. Hyperpigmentation reactions can be distressing patients lead decreased adherence; given widespread use HCQ, it important increase awareness this potential reaction.