Sodium Valproate-Induced Hyperpigmentation

An 11-year-old boy presented with hyperpigmentation over the perioral region, eyelids, and right forehead. These pigmentations had developed slowly over the prior 9 months, which coincided with the initiation of oral sodium valproate (after 4 weeks of initiation) for his primary generalized epilepsy. He was not taking any other medications, and there were no reports of rash, photosensitivity, itching, skin excoriation or ulceration, eczematous or non-eczematous dermatitis, erythema, or other systemic complaints.