Blue velvet - Pseudocyanosis, a rare case of drug-induced bluish hyperpigmentation with clozapine : A case report

Article Article scientifique Rapport de cas Blue velvet - Pseudocyanosis, a rare case of drug-induced bluish hyperpigmentation with clozapine : A case report eng 2025-09-05 author Mazza Tina Division of General Internal Medicine, Department of Medicine, University Hospitals, Genève, Switzerland. 746055 author David Antoine Department of Dermatology and Venereology, University Hospital of Geneva, Genève, Switzerland. 824566 author Kaya Guerkan Department of Dermatology and Venereology, University Hospital of Geneva, Genève, Switzerland.,Department of Clinical Pathology, University Hospital of Geneva, Genève, Switzerland. 26603 Département de médecine (DEMED) author Menzinger Sébastien Department of Dermatology and Venereology, University Hospital of Geneva, Genève, Switzerland.,Department of Clinical Pathology, University Hospital of Geneva, Genève, Switzerland. 633099 author Berner Amandine Division of General Internal Medicine, Department of Medicine, University Hospitals, Genève, Switzerland. 643966 author Serratrice Jacques Division of General Internal Medicine, Department of Medicine, University Hospitals, Genève, Switzerland. 836481 Département de médecine (DEMED) author Coen Matteo 0000-0002-6156-1691 Division of General Internal Medicine, Department of Medicine, University Hospitals, Genève, Switzerland.,Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Genève, Switzerland. 601519 Département de médecine (DEMED) e44120 10.1097/MD.0000000000044120 40922295 0025-7974 PMC12419416 https://journals.lww.com/md-journal/fulltext/2025/09050/blue_velvet___pseudocyanosis,_a_rare_case_of.60.aspx Rationale: This case highlights the importance of considering a wide range of possible diagnoses when faced with unexplained hemorrhagic symptoms. When standard investigations fail to identify a clear cause, it is essential to conduct a detailed dietary history. This can lead to the diagnosis of scurvy, a reversible vitamin C deficiency that is often overlooked in populations at risk. Patient concerns: The patient is a 55-year-old man with well-controlled Crohn disease who presented with unexplained bilateral leg pain and extensive hematomas on his lower limbs, significantly affecting his mobility and raising concerns about a serious condition. Diagnoses: The final diagnosis was scurvy, resulting from a chronic deficiency of vitamin C due to a severely limited diet that lacked fruits and vegetables. Initially, differential diagnoses included deep vein thrombosis and drug-induced coagulopathy. However, a physical examination revealed follicular purpura, and the identified dietary restrictions ultimately led us to the correct diagnosis and enabled effective treatment. Interventions: Vitamin C supplementation was initiated. Outcomes: Timely identification and vitamin C supplementation resulted in a rapid improvement in the patient's condition. Lessons: This case highlights the importance of recognizing nutritional deficiencies in modern medicine, especially for patients with chronic illnesses. It demonstrates that classic diseases, such as scurvy, can still occur and be overlooked if comprehensive patient histories and thorough examinations are not conducted. Atypical antipsychotics Case report Pigmentation Skin discoloration Humans Male Middle Aged Scurvy / diagnosis Scurvy / drug therapy Scurvy / etiology Ascorbic Acid / therapeutic use Ascorbic Acid / administration & dosage Clozapine / adverse effects Antipsychotic Agents / adverse effects Crohn Disease / drug therapy Hyperpigmentation / chemically induced Dietary Supplements Diagnosis, Differential Dewey 610/370 Dewey 616.07 Dewey 616 137 Département de pathologie et immunologie 21F 56 Département de médecine 221 48 Unité de développement et de recherche en éducation médicale 204 false 478 Vieillissement cutané 809 Medicine 104 36 9d0b760d-8119-48cb-99ae-1b096fc0cf55 Article (Published version) Public Article_scientifique_from_europePmc.pdf 492680 application/pdf CC BY-4.0 9a5b626559df75f0e35d4221ebab336d8f540e621aa06987e3b3b271155e0b75 openAccess Faculté de médecine / Section de médecine fondamentale / Département de pathologie et immunologie Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Unité de développement et de recherche en éducation médicale

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Blue velvet - Pseudocyanosis, a rare case of drug-induced bluish hyperpigmentation with clozapine : A case report	Medicine	2025	14	177
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Mazza, Tina