Hyperpigmentation in Acute Leukemia Treated with Folic Acid Antagonists.

Abstract

Hyperpigmentation of the skin was observed in several patients with acute leukemia receiving aminopterin or alpha-methopterin for several mos. Histologic studies confirmed the impression that true melanogenesis had occurred. Some abberration in melanin formation occurred beyond that which is seen in chronic disease states. Since tyrosinases as a group are concerned in melanogenesis, the function of the enzymes might be influenced by the folic acid antagonists. Whether the Cu containing enzymes as found in the tyrosinases are influenced through the sulfhydryl groups remains to be investigated. Some indirect evidence exists to relate tyrosine metabolism to folic acid, and this relationship may play a part in the hyperpigmentation.