Year: 2025
Type: article
Study design: Case Report
Abstract: Introduction: Hydroquinone is topical depigmenting agent that is frequently used to treat hyperpigmentation disorders. Prolonged contact exposure can lead to asymptomatic, reversible orange discoloration of the nail plate. Case Presentation: A 52-year-old woman of Hispanic ethnicity presented to our dermatology clinic for follow-up of melasma, 2 months after initiating hydroquinone therapy. She also was taking isoniazid and rifampin therapies for reactivated tuberculosis. On physical examination, she had sharply demarcated, non-blanching, orange-brown areas of discoloration affecting the distal fingernails. Nail clipping histopathology and serologic testing for vitamin deficiencies, complete cell blood count, and liver and renal functioning were unremarkable. After ruling out alternative etiologies and considering causes such as antituberculosis treatment, a diagnosis of orange nail discoloration secondary to topical hydroquinone use was rendered. Conclusion: The differential diagnosis for orange chromonychia is broad and requires a thorough workup to rule out autoimmune diseases, organ failure (cardiac, hepatic, renal), and vitamin or mineral deficiencies. It is important to consider comorbidities, medications, and contact and exogenous exposures into consideration. Awareness and patient education of this rare side effect may prevent unnecessary distress and, in some cases, avoid unnecessary testing.
Source: Case Reports in Dermatology
DOI: 10.1159/000549766
Institutions: New York University, Weill Cornell Medicine
Language: English
Topic: Nail Diseases and Treatments
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,030
OpenAlex ID: W4416869374