Drug-induced Hyperpigmentation due to Levofloxacin

Drug-induced hyperpigmentation is responsible for up to 20% of acquired hyperpigmentation cases, especially among the elderly population. The pathogenesis varies depending on the medication involved and may include melanin accumulation, drug deposition, production of special pigments, and iron deposition. We report the case of an elderly, immunocompromised patient with a history significant for leukemia presenting with black-blue hyperpigmentation of the upper and lower extremities, associated with iron deposition following levofloxacin exposure.