Daunorubicin has been reported to cause hyperpigmentation of sun-exposed skin and/or transverse nail pigmentation (3 cases). We report a case of an African American man who had an atypical pattern of generalized hyperpigmentation develop that involved many sun-protected skin areas 2 weeks after daunorubicin treatment. Histopathology of hyperpigmented skin showed increased melanin granules in all epidermal layers. The mechanisms by which daunorubicin may increase skin pigmentation are discussed.