A 24 year-old-woman presented with a one-year history for facial hyperpigmentation...

 What is your diagnosis?

Diagnosis: Amiadarone induced pigmentation

Pigmentation may be induced by a wide variety of drugs including heavy metals, phenothiazines, antimalarial drugs and amiodarone. Drug-induced hypermelanosis may be melanin or non-melanin related.

A gray-blue pigmentation of the face and other sun-exposed areas is sometimes seen in patients on amiodarone as our case. The pigmentation resembles that of argyria. Histopathologically, yellow-brown pigment granules are seen within macrophages situated principally around blood vessels in the upper reticular dermis. 

Sudan Black B staining revealed pigment in this case.