Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur while taking hydroxychloroquine: Incidence not known Some side effects of hydroxychloroquine may occur that usually do not need medical attention. Chloroquine cytotoxic hemozoin falicparum Hydroxychloroquine moa lupus Plaquenil and valacyclovir Long-term progression of hydroxychloroquine retinopathy off the drug marmor About 25% of patients receiving chloroquine or hydroxychloroquine for several years develop bluish-grey pigmentation on face, neck and sometimes lower legs and forearms Continuous long-term use may lead to blue-black patches, especially in sun-exposed areas We report two cases of hydroxychloroquine-induced hyperpigmentation presenting in a 50-year-old Caucasian female case 1 and a 78-year-old female case 2, both receiving 400 mg per day. Case 1 had an arthritis predominant undifferentiated connective tissue disease, which was treated with hydroxychloroquine for 4-5 years. The hydroxychloroquine was indicated for systemic lupus erythematosus in 73.2%, dermatomyositis in 12.2%, rheumatoid arthritis in 9.8%, actinic lichen and sarcoidosis each in 2.4%. Cutaneous pigmented lesions were found in 21 cases 51%, mucous pigmentation in 5 cases 12% and nail pigmentation in 1 case 2.5%. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. These side effects may go away during treatment as your body adjusts to the medicine. Hydroxychloroquine pigmentation histology Hydroxychloroquine-Induced Hyperpigmentation JCR., Hydroxychloroquine-induced hyperpigmentation the staining pattern. Hydroxychloroquine sul tabs 200 mgPlaquenil to treat lupusPlaquenil help trans mylitis Deposits in these cells can lead to cutaneous pigmentation and possibly retinal toxicity. Hydroxychloroquine breaks down into two pharmacologically active metabolites — desethyl-hydroxychloroquine and desethyl-chloroquine. After a single dose, hydroxychloroquine is excreted mainly in the faeces, and only 20% is excreted unchanged in the urine. Hydroxychloroquine DermNet NZ. Hydroxychloroquine-induced hyperpigmentation in systemic.. Hydroxychloroquine Side Effects Common, Severe, Long Term.. Hydroxychloroquine Plaquenil stimulates the pigment producing cells in the skin called melanocytes. As a result, there is both hemosiderin iron and melanin accumulation in the dermis. The exact reasons why this phenomenon happens is not clear. However, trauma and bruising may faciliate the developement of pigmentation. Common, usually harmless condition, in which patches of skin become darker than normal surrounding skin Wikipedia Due to melanocyte stimulation from drugs Merck, heat, hormones, inflammation eMedicine, malignancy, metabolic disease, scars, sunlight, various dermatoses or familial progressive hyperpigmentation Eur J Dermatol 2006;6 Hydroxychloroquine typically is very well tolerated. Serious side effects are rare. The most common side effects are nausea and diarrhea, which often improve with time. Less common side effects include rash, changes in skin pigment such as darkening or dark spots, hair changes, and muscle weakness.