Variations in Pigmentation from Quinacrine

During World War II, diffuse yellow discoloration of the skin resulting from ingestion of quinacrine hydrochloride (Atabrine, Mepacrine) was a common sight to medical personnel in the southwest Pacific area. An uncommon and less well-known manifestation of the prolonged use of quinacrine is the development of dark blue-black or gray pigmentation in such places as the nail beds and hard palate. The association of these two varieties of pigment now is considered to be characteristic of the prolonged ingestion of quinacrine. The infrequent use of this antimalarial agent today, particularly in nontropical countries, is the probable reason for its failure to be considered in the differential diagnosis of jaundice. The paucity of the literature related to this problem since World War II and the difficulties that may be encountered in an instance of simulated jaundice induced by the use of quinacrine have prompted this report. Review of the Literature Quinacrine