Reversible Nail Discoloration from Hydroquinone 4% Cream
Journal Title: Journal of Clinical and Investigative Dermatology - Year 2018, Vol 6, Issue 1
Abstract
Introduction: Hydroquinone is a tyrosinase-inhibiting phenolic compound widely prescribed for disorders of pigmentation such as melasma, lentigines and post inflammatory hyper pigmentation. Well-known adverse effects of topical hydroquinone include allergic contact dermatitis and exogenous ochronosis after long-term use. Pigmentation of the nails is another relatively uncommon yet reversible treatment complication. Observation: A 38-year-old female presented with hyperpigmentation of her fingernails after daily application of 4% hydroquinone to the face for 3 months. Physical examination revealed brownish, ill-defined, macular discoloration 4-6 mm distal to the proximal nail fold and the fourth and fifth fingernail beds of both hands but with more pronounced involvement of the right fingernails. Examination of the palms showed brownish discoloration of calluses overlying the heads of the metacarpals. The brown discoloration of the fingernails could not be scrapped off with a 15-blade. Nail clippings sent for histopathology were notable for amorphous yellowbrown globules with Fontana-Masson staining. The nail pigmentation ultimately resolved 2 months after cessation of the hydroquinone product. Conclusion: Hydroquinone-containing creams are widely available over the counter, and hydroquinone is generally considered safe and effective at concentrations of 4% or less. Although uncommon and self-limited, nail hyperpigmentation after topical hydroquinone is a possible side effect that dermatologists should be aware of. Considering the increasing use of hydroquinone-containing products for aesthetic purposes in the cosmetic area, not only dermatologists but also other cosmetic practitioners should be familiar with this potential complication to better inform their patients.
Authors and Affiliations
Thais Prota Hussein Pincelli
Keywords
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- EP ID EP496610
- DOI 10.13188/2373-1044.1000052
- Views 76
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