Long-term administration of either chloroquine or hydroxychloroquine can lead to ocular complications ranging from corneal opacity, to transient visual changes, to irreversible retinopathy and blindness.29 Hydroxychloroquine has a lower risk of ocular toxicity, but it may not be as effective in treating sarcoidosis.12,29 When prolonged therapy with any antimalarial compound is contemplated, baseline and periodic ophthalmological examinations should be performed.37,38 Other side-effects include nausea and vomiting, gastrointestinal upset, central nervous system toxicity (irritability, nervousness, depression), neuromuscular reactions (skeletal muscle palsies, myopathy or neuromyopathy) and cutaneous pigmentation. Millard et al39 report on a male patient treated with chloroquine for sarcoidosis who developed a widespread bullous eruption after 3 months of therapy consistent with drug-induced bullous pemphigoid.

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