Skin Discoloration from Amiodarone

This case describes an 81-year-old man with longstanding atrial fibrillation who presented after a fall and was noted to have blue-gray facial pigmentation (ceruloderma), particularly on the nose, cheeks, and forehead, sparing deep skin folds. He had been on amiodarone therapy for 15 years, initiated for atrial fibrillation with rapid ventricular response. The fall was attributed to orthostatic hypotension. During hospitalization, amiodarone was discontinued, yet skin discoloration persisted at a 6-month follow-up. The case highlights amiodarone-induced pigmentation as a rare side effect and notes the importance of reassessing long-term medication use in light of adverse effects and changing clinical status.

This case describes an 81-year-old man with longstanding atrial fibrillation who presented after a fall and was noted to have blue-gray facial pigmentation (ceruloderma), particularly on the nose, cheeks, and forehead, sparing deep skin folds. He had been on amiodarone therapy for 15 years, initiated for atrial fibrillation with rapid ventricular response. The fall was attributed to orthostatic hypotension. During hospitalization, amiodarone was discontinued, yet skin discoloration persisted at a 6-month follow-up. The case highlights amiodarone-induced pigmentation as a rare side effect and notes the importance of reassessing long-term medication use in light of adverse effects and changing clinical status.