Atypical Bilateral Hyperpigmented Macules on the Lower Legs Possibly Due to Cyclophosphamide

This document presents a case of atypical bilateral hyperpigmented macules on the lower legs, possibly induced by cyclophosphamide, a chemotherapeutic agent. The patient exhibited xerotic skin with brownish discoloration and black scales, along with diffuse pigmented macules on the nail beds and tongue. Dermoscopic examination showed brownish unstructured areas and black dots, while a biopsy revealed increased melanin in the basal and stratum corneum. The study concludes that although the exact mechanism is unknown, cyclophosphamide likely causes cutaneous hyperpigmentation through direct stimulation of hair follicles.