The Blue-Gray Man Mystery

An 81-year-old man on multiple heart medications presents with facial discoloration after a fall. Explore the differential for this unusual skin finding.

Amiodarone-induced skin discoloration


An 81-year-old man with a history of atrial fibrillation and hypertension presented to the emergency department after a fall. His medications were apixaban, ramipril, bisoprolol, amlodipine, and amiodarone. Physical examination showed discoloration of his nose, cheeks, and forehead. What is the most likely diagnosis?

What is the most likely diagnosis?

Methemoglobinemia
Lupus pernio
Silver toxicity
Amiodarone-induced skin discoloration
Eisenmenger syndrome

Adverse Drug Reaction, Amiodarone-induced skin discoloration, Cardiology, Dermatology, Hyperpigmentation

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