Drug-induced pigmentation: amiodarone A striking slate-gray pigmentation in a photodistribution of the face. The blue color (ceruloderma) is due to the deposition of melanin and lipofuscin contained in macrophages and endothelial cells in the dermis. The pigmentation is reversible, but it may take up to a year or more to complete resolution. In this patient it took 33 months for the ceruloderma to disappear.
Addison’s disease. Hyperpigmentation representing an accentuation of normal pigmentation of the hand of a patient with Addison’s disease (left). For comparison, the hand of a normal individual, matched for ethnic pigmentation, is shown on the right.