## Clofazimine: Pigmentation and MDT Role ### Mechanism of Discoloration **Clofazimine** is a lipophilic riminophenazine compound that accumulates in fatty tissues and causes: - **Brown-black discoloration** of skin (ichthyosis-like appearance) - **Discoloration of body secretions:** tears, sweat, urine, feces - **Reversible pigmentation** that fades 6–12 months after discontinuation ### Role in MDT | Aspect | Detail | |--------|--------| | **Drug class** | Riminophenazine | | **Mechanism** | Generates reactive oxygen species; bacteriostatic against *M. leprae* | | **Dosing** | 50 mg daily (unsupervised) | | **Indication** | All forms of leprosy (paucibacillary and multibacillary) | | **Side effect** | Brown-black pigmentation (most notable) | ### Clinical Significance **High-Yield:** Clofazimine discoloration is a **hallmark side effect** frequently tested in NEET PG. It is: - Cosmetically concerning but harmless - Reversible upon cessation - A sign of drug compliance **Key Point:** The pigmentation is NOT a sign of toxicity; it reflects drug accumulation in lipid-rich tissues and is expected. **Clinical Pearl:** Counsel patients about this side effect before starting therapy to improve adherence and prevent premature discontinuation. 
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