Amiodarone-induced pigmentation resolves after treatment with the Q-switched ruby laser.

A 55-year-old woman presented with a 3-year history of diffuse blue-gray pigmentation on the nose, cheeks, and upper lips with sparing of the skin flexures. She had been treated with amiodarone for approximately 10 years because of severe cardiac arrhythmia with a cumulative dose of more than 900 g and a maintenance dose of 250 mg/d. She was taking no other medication. Results of light microscopy of a biopsy specimen from the discolored skin showed granular yellow-brown pigment in the cytoplasm of dermal melanophages at the junction of the papillary and reticular dermis (Figure 1 and Figure 2). Results of iron stain testing were negative.