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Figure 1. A 61-year-old man who had had a defibrillator implanted after a cardiac arrest in 1989 was treated with amiodarone in 1990 because of frequent shocks from the defibrillator. After an initial loading dose, a maintenance dose of 400 mg daily was begun, and the patient had no further shocks. The dose was decreased to 200 mg daily in 1995, and the drug was discontinued in 1996. During therapy blue-gray pigmentation of the patient's nose, lips, and cheeks occurred, with sparing of the forehead and the area around the eyes. The patient commonly wore a hat and sunglasses when outside. At the most recent follow-up visit, the pigmentation remained unchanged.
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