Safety of Hydroxychloroquine: What a Dermatologist Should Know.

Michelangelo La Placa, Michela Starace, Bianca Maria Piraccini, Emanuel Raschi, Stephano Cedirian, Luca Rapparini

Journal: American journal of clinical dermatology 2025;26(2):251-264

PMID: 39899183

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Abstract

The unique immunomodulatory properties of hydroxychloroquine (HCQ) have attracted considerable interest beyond its use for malaria and rheumatological diseases, including a variety of dermatological conditions. Over recent years, especially after the coronavirus disease 2019 (COVID-19) pandemic, the prescription of HCQ has also significantly expanded, sometimes inappropriately, thus posing additional challenges on its optimal use, due to emerging safety issues. In this review, we provide dermatologists with the latest advancements on selected clinically relevant toxicities, namely retinopathy, pro-arrhythmia, cutaneous reactions, and neuropsychiatric effects. It is hoped this update can assist dermatologists to identify high-risk patients for tailored monitoring, screening, and risk minimization strategies, thus supporting safer HCQ prescribing.

Address: Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy.; Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.; Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy. [email protected].; Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy. [email protected].; Pharmacology Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.

DOI: 10.1007/s40257-025-00919-x

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https://dx.doi.org/10.1007/s40257-025-00919-x

MeSH Terms: Humans, Hydroxychloroquine, COVID-19 Drug Treatment, COVID-19, Skin Diseases, SARS-CoV-2, Dermatologists, Dermatology