Hyperpigmentation, which develops secondary to drugs, is generally due to the accumulation of the drugs on the skin. Isotretinoin is synthetic deriva-tive of vitamin A and it is the 13-cis retinoic acid form of a retinoid. A 20-year-old female patient presented to the dermatology outpatient clinic with complaints of brown stains on the nose. The medical history also revealed that the patient had been using isotretinoin 30 mg/day for the last six months for acne and no other oral or topical drug use was present. Her dermatological examination revealed that a gray macule of 1x1 cm was present in the left nasal wing. The dermatoscopic examination of the lesion revealed thin, gray, pigmented structures in particular, surrounding the follicular openings. The absence of pigmentation defects due to systemic isotretinoin use in the literature review has led us to present the current case.