Exogenous ochronosis resulting from quinine injections.

An 86-year-old woman presented with bluish black macules on each buttock. Skin biopsy revealed ochronotic pigment in the dermis. On the basis of negative results of a urine test for alkaptonuria and a history of having received quinine injections for malaria 70 years ago, the patient was diagnosed as having localized exogenous ochronosis resulting from quinine injections. Exogenous ochronosis has been reported following the topical use of phenol in leg ulcers, the topical use of hydroquinone bleaching creams in black persons, and the oral administration of antimalarials for malaria and connective tissue diseases, but we could find no reports in the literature of exogenous ochronosis following intramuscular injections of antimalarials.