ABSTRACT
The antimalarials have been commonly described for the treatment of several connective tissue diseases. Among adverse effects of antimalarials, skin hyperpigmentation has been easily overlooked for its slow onset, but it may be a marker at risk of ocular side effects. Moreover, most cases of hyperpigmentation have been reported from chloroquine, but rarely hydroxychloroquine (HCQ). We experienced two patients who showed skin pigmentation during administration of HCQ. The first case was a 53-year-old woman presented with dark brown macules on the neck and ashy-colored patches on the buttock. The second was a 75-year-old woman presented with bluish-gray patches on both shins. Before hyperpigmentation developed, each patient had been treated with HCQ 400 mg per day for two years and five months, respectively. Two years ago after skin hyperpigmentation the first patients was found to have retinal pigmentation under the fundoscopy, so that HCQ was discontinued.