Blue-Black Pigmentation of the Legs Associated With Pefloxacin Therapy

Abstract

Cutaneous side effects of pefloxacin, a quinolone antibiotic, occur in 1.3% of treated patients and include photosensitivity, rash, pruritus, and a few cases of itchy erythema on face and forearms. 1 We report the first case of a blue-black pigmentation of the legs associated with pefloxacin therapy reminiscent of the well-described skin pigmentation associated with minocycline therapy. 1-3 Report of a Case. A 60-year-old woman was admitted in June 1993 for extensive lymphedema of both legs and areas of blue-black macular pigmentation of the extensor surface of the lower legs and the dorsa of the feet ( Figure 1 ). Since 1961, she had multiple sclerosis that induced a com Figure 1. Blue-black skin pigmentation of the legs associated with pefloxacin therapy. Figure 2. Biopsy specimen of pigmented skin (Perls' stain, ×1000). These dense deposits of black pigments were positive for Prussian blue, indicating the presence of iron. plete paralysis and lymphedema