{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T15:29:03Z","timestamp":1788276543809,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T00:00:00Z","timestamp":1775347200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T00:00:00Z","timestamp":1775347200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Kratom (\n                    <jats:italic>Mitragyna speciosa<\/jats:italic>\n                    ) is a commonly used over\u2010the\u2010counter supplement with opioid\u2010like and dopaminergic activity. Cutaneous side effects have been incompletely characterized; only limited case reports describe its associated hyperpigmentation. We describe two cases of kratom\u2010induced photodistributed brown\u2010gray patches with biopsies that show circular, orange\u2010brown granules in the dermis that stain positive with Fontana\u2010Masson and negative for iron. In conjunction with existing literature, our cases suggest a possible distinct clinicopathologic pattern for which kratom use can be suspected.\n                  <\/jats:p>","DOI":"10.1111\/cup.70087","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T02:38:23Z","timestamp":1775443103000},"page":"893-897","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Kratom\u2010Induced Hyperpigmentation: An Emerging Clinicopathologic Pattern"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9343-0314","authenticated-orcid":false,"given":"Matthew H.","family":"Friedland","sequence":"first","affiliation":[{"name":"Department of Dermatology Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Dermatology Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret S.","family":"Johnston","sequence":"additional","affiliation":[{"name":"Four Seasons Dermatology  Colchester Vermont USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Correale","sequence":"additional","affiliation":[{"name":"Department of Dermatology Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2270-2524","authenticated-orcid":false,"given":"Christine J.","family":"Ko","sequence":"additional","affiliation":[{"name":"Department of Dermatology Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,5]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Substance Abuse and Mental Health Services Administration \u201cKey Substance Use and Mental Health Indications in the United States: Results From the 2021 National Survey on Drug Use and Health (HHS Publication No. PP22\u201007\u201001\u2010005. NSDUH Serioes\u201057) \u201d(2022) Center for Behavioral Health Statistics and Quality. Substance Abuse and Mental Health Services Administration."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40429\u2010023\u201000478\u20103"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2022.07.033"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.16650"},{"key":"e_1_2_9_6_1","first-page":"21","article-title":"A Study of Kratom Eaters in Thailand","volume":"27","author":"Suwanlert S.","year":"1975","journal-title":"Bulletin on Narcotics"},{"key":"e_1_2_9_7_1","first-page":"1","article-title":"Photodistributed Hyperpigmentation in a Chronic Kratom User","volume":"2","author":"Suleman S.","year":"2023","journal-title":"International Clinical Medicine Case Reports Journal"},{"key":"e_1_2_9_8_1","article-title":"Photo Distributed Gray\u2010Blue Hyperpigmentation due to Kratom Use","author":"Patel S.","year":"2024","journal-title":"Journal of Integrative Dermatology"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.79804"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2025.02.017"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.12788\/cutis.1100"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2016.00464"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1021\/acs.jmedchem.9b01465"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/bkz108"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/20.6.338"},{"key":"e_1_2_9_16_1","first-page":"1134","volume-title":"Dermatology","author":"Weston G. K.","year":"2025"},{"issue":"2","key":"e_1_2_9_17_1","first-page":"179","article-title":"Diltiazem\u2010Associated Photodistributed Hyperpigmentation: A Review of 4 Cases","volume":"137","author":"Scherschun L.","year":"2001","journal-title":"Archives of Dermatology"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0190\u20109622(87)70101\u20107"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100560.2008.01004.x"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2013.709"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1383343"},{"issue":"3","key":"e_1_2_9_22_1","first-page":"E8","article-title":"Imipramine\u2010Induced Hyperpigmentation","volume":"100","author":"Bicknell L. 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