Blue Pigmentation of the Skin, Sclera, and Teeth | Dermatology | JN Learning | AMA Ed Hub [Skip to Content]
[Skip to Content Landing]

Blue Pigmentation of the Skin, Sclera, and Teeth

Educational Objective
Based on this clinical scenario and the accompanying image, understand how to arrive at a correct diagnosis.
1 Credit CME

Please finish quiz first before checking answer.

You answered correctly!

Read the answer below and download your certificate.

You answered incorrectly.

Read the discussion below and retake the quiz.

Survey Complete!

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 CME Credit™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: Misha Rosenbach, MD, Department of Dermatology, University of Pennsylvania, 3600 Spruce St, 2 Maloney, Philadelphia, PA 19104 (Misha.Rosenbach@pennmedicine.upenn.edu).

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank David E. Elder, MBChB (University of Pennsylvania Perelman School of Medicine) for his work in evaluating the biopsy and highlighting histopathologic features important for determining this patient’s diagnosis. We thank the patient for granting permission to publish this information.

References
1.
Lorente  M , Ballano  A , Juanes  A , Pastor  MA , Cuevas  J .  Blue-gray pigmentation in trunk and extremities in a 71-year-old man.   JAMA Dermatol. 2013;149(9):1111-1112. doi:10.1001/jamadermatol.2013.4365PubMedGoogle ScholarCrossref
2.
Bolognia  JL , Schaffer  JV , Cerroni  L . Dermatology. Elsevier; 2017.
3.
Kowdley  KV , Brown  KE , Ahn  J , Sundaram  V .  ACG Clinical Guideline: hereditary hemochromatosis.   Am J Gastroenterol. 2019;114(8):1202-1218. doi:10.14309/ajg.0000000000000315PubMedGoogle ScholarCrossref
4.
Dwyer  CM , Cuddihy  AM , Kerr  REI , Chapman  RS , Allam  BF .  Skin pigmentation due to minocycline treatment of facial dermatoses.   Br J Dermatol. 1993;129(2):158-162. doi:10.1111/j.1365-2133.1993.tb03519.xPubMedGoogle ScholarCrossref
5.
Hanada  Y , Berbari  EF , Steckelberg  JM .  Minocycline-induced cutaneous hyperpigmentation in an orthopedic patient population.   open forum infect dis. 2016;3(1):ofv107. doi:10.1093/ofid/ofv107PubMedGoogle Scholar
6.
Roberts  G , Capell  HA .  The frequency and distribution of minocycline induced hyperpigmentation in a rheumatoid arthritis population.   J Rheumatol. 2006;33(7):1254-1257.PubMedGoogle Scholar
7.
Okada  N , Sato  S , Sasou  T , Aoyama  M , Nishida  K , Yoshikawa  K .  Characterization of pigmented granules in minocycline-induced cutaneous pigmentation: observations using fluorescence microscopy and high-performance liquid chromatography.   Br J Dermatol. 1993;129(4):403-407. doi:10.1111/j.1365-2133.1993.tb03166.xPubMedGoogle ScholarCrossref
8.
Argenyi  ZB , Finelli  L , Bergfeld  WF ,  et al.  Minocycline-related cutaneous hyperpigmentation as demonstrated by light microscopy, electron microscopy and X-ray energy spectroscopy.   J Cutan Pathol. 1987;14(3):176-180. doi:10.1111/j.1600-0560.1987.tb00493.xPubMedGoogle ScholarCrossref
9.
Nakamura  S , Yokozeki  H , Nishioka  K .  Acute pigmentation due to minocycline therapy in atopic dermatitis.   Br J Dermatol. 2003;148(5):1073-1074. doi:10.1046/j.1365-2133.2003.05271.xPubMedGoogle ScholarCrossref
10.
Green  D , Friedman  KJ .  Treatment of minocycline-induced cutaneous pigmentation with the Q-switched Alexandrite laser and a review of the literature.   J Am Acad Dermatol. 2001;44(2)(suppl):342-347. doi:10.1067/mjd.2001.103036PubMedGoogle ScholarCrossref
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_Multimedia_LoginSubscribe_Purchase
Close
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_Multimedia_LoginSubscribe_Purchase
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
Close
With a personal account, you can:
  • Track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
jn-learning_Modal_SaveSearch_NoAccess_Purchase
Close

Lookup An Activity

or

Close

My Saved Searches

You currently have no searches saved.

Close

My Saved Courses

You currently have no courses saved.

Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close