Oral hyperpigmentation in HIV-infected patients

Langford, A.; Pohle, H. D.; Gelderblom, Hans R.; Zhang, X.; Reichart, Peter A.

doi:10.1016/0030-4220(89)90360-5

Cited by 51 publications

(39 citation statements)

References 23 publications

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“…There were no differences in the prevalence of intra-oral pigmentation between males and females. Increased melanin pigmentation in skin and oral mucosa have been reported by Langford et al, 36 Smith et al 37 and Ceballos-Salobrena et al 38 Some of the reasons that have been put forward to explain the intraoral pigmentation are increased release of α-melanocytestimulating hormone (α-MSH) due to deregulated release of cytokines in HIV disease; use of melanocyte stimulating drugs: certain antiretrovirals, antifungals; and Addison's disease. When the prevalence of pigmentation was compared between gender and within the gender between CD4 counts <200 and CD4 counts >200, we did not observe any significant difference.…”

Section: Discussionmentioning

confidence: 99%

Oral lesions and conditions associated with human immunodeficiency virus infection in 300 south Indian patients

Ranganathan¹,

Reddy²,

Kumarasamy³

et al. 2000

Oral Diseases

159

160

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BACKGROUND: Human immunodeficiency virus infection/ acquired immunodeficiency syndrome (HIV/AIDS) is a major health problem in India. The National AIDS Control Organisation (NACO) of India reports a seropositivity of 25.03 per thousand for the whole country, as of October 1999. In spite of this high prevalence there are very few reports of oral lesions and conditions in Indian HIV/AIDS patients, which are important in early diagnosis and management of these patients. OBJECTIVE AND SETTING: The present report describes the oral lesions in 300 HIV positive symptomatic patients presenting to us at RAGAS‐YRG CARE, a non‐governmental organisation in Chennai, South India, over a period of 9 months in 1998. METHOD: Lesions were diagnosed on clinical appearance using international criteria. RESULTS: Of the 300 patients 89% had acquired the infection through heterosexual contact. There were 205 males and 95 females, aged from 7 months to 72 years. Forty‐seven percent of the patients were in the age group 21–30 years. CD4 counts were ascertained for 105 patients, 64 (62%) had CD4 counts ≤200. A total of 217 (72%) of the 300 patients had some oral lesion when examined. Gingivitis (47%) and pseudomembranous candidiasis (33%) were the most common oral lesions. The other oral lesions seen were oral mucosal pigmentation (23%), erythematous candidiasis (14%), periodontitis (9%), angular cheilitis (8%), oral ulcers (3%), oral hairy leukoplakia (3%), hyperplastic candidiasis (1%), oral submucous fibrosis (2%) and one case of leukoplakia. CONCLUSIONS: Oral lesions occur commonly in HIV infection. A comprehensive oral examination may not only suggest HIV disease but may also be useful in monitoring the disease progression. This is a cost‐effective procedure, which may be useful in screening large populations in developing countries like India.

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Section: Discussionmentioning

confidence: 99%

Oral lesions and conditions associated with human immunodeficiency virus infection in 300 south Indian patients

Ranganathan¹,

Reddy²,

Kumarasamy³

et al. 2000

Oral Diseases

159

160

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“…(HIV AND CD4) In patients infected with Human Immunodeficiency virus (HIV), progressive hyper pigmentation of the skin, oral mucosa, finger nails and toe nails have been reported, being related to primary adrenocortical deficiency or to zidovudine therapy in some cases. 36 clinically, oral pigmentation appears as irregular macules with brown or dark brown color. The tongue, buccal mucosa, and palate are the most commonly affected sites.…”

Section: Zidovudinementioning

confidence: 99%

“…36,37 The mechanism of pigmentation may be related to the red color of the metabolized drug; however, there is also increased melanin deposition for which there is no obvious explanation.…”

Section: Clofaziminementioning

confidence: 99%

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Drugs Causing Orofacial Pigmentation: An Overview of Literature

Hasan¹,

Khan²,

Sherwani³

et al. 2013

Int. Res. J. Pharm.

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The term "Oro-facial pigmentation" refers to a wide range of lesions or conditions featuring a change of color of Oro-facial tissues. Pigmentation of the Orofacial tissues is seen in certain races or ethnic groups such as Indians, Africans and Europeans. Broadly classifying, Oro-facial pigmentation is divided into endogenous pigmentation and exogenous pigmentation. Endogenous pigmentation is due to pigments produced within the body. Exogenous pigmentation occurs when foreign bodies get impregnated into the oral mucosa and appear as localized area of altered pigmentation. Drug constitutes an important endogenous cause of Oro-facial pigmentation. Hereby, we are presenting an overview of various drugs in the etio-pathogenesis of Oro-facial pigmentation.

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“…1,2 The prevalence of HIV-associated oral melanin hyperpigmentation (HIV-OMP) is relatively low in Italy (6.4%), in Tanzania (4.7%), and in Kenya (6%), [3][4][5] but is high in Venezuela (38%) 6 and in India, where it ranges from about 26% 7 to about 30%. 8 There is some evidence that highly active antiretroviral therapy (HAART) influences HIV melanosis: in one study from southern India, the frequency of oral hyperpigmentation in HIV-seropositive subjects on HAART was 38% and in HAART-naive subjects was 20%.…”

Section: Introductionmentioning

confidence: 99%

Melanocyte Biology and Function with Reference to Oral Melanin Hyperpigmentation in HIV-Seropositive Subjects

Feller

Chandran

Kramer

et al. 2014

AIDS Research and Human Retroviruses

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The color of normal skin and of oral mucosa is not determined by the number of melanocytes in the epithelium but rather by their melanogenic activity. Pigmented biopolymers or melanins are synthesized in melanosomes. Tyrosinase is the critical enzyme in the biosynthesis of both brown/black eumelanin and yellow/red pheomelanin. The number of the melanosomes within the melanocytes, the type of melanin within the melanosomes, and the efficacy of the transfer of melanosomes from the melanocytes to the neighboring keratinocytes all play an important role in tissue pigmentation. Melanin production is regulated by locally produced factors including proopiomelanocortin and its derivative peptides, particularly alpha-melanocyte-stimulating hormone (α-MSH), melanocortin 1 receptor (MC1R), adrenergic and cholinergic agents, growth factors, cytokines, and nitric oxide. Both eumelanin and pheomelanin can be produced by the same melanocytes, and the proportion of the two melanin types is influenced by the degree of functional activity of the α-MSH/MC1R intracellular pathway. The cause of HIV oral melanosis is not fully understood but may be associated with HIV-induced cytokine dysregulation, with the medications commonly prescribed to HIV-seropositive persons, and with adrenocortical dysfunction, which is not uncommon in HIV-seropositive subjects with AIDS. The purpose of this article is to discuss some aspects of melanocyte biology and HIV-associated oral melanin hyperpigmentation.

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Oral hyperpigmentation in HIV-infected patients

Cited by 51 publications

References 23 publications

Oral lesions and conditions associated with human immunodeficiency virus infection in 300 south Indian patients

Oral lesions and conditions associated with human immunodeficiency virus infection in 300 south Indian patients

Drugs Causing Orofacial Pigmentation: An Overview of Literature

Melanocyte Biology and Function with Reference to Oral Melanin Hyperpigmentation in HIV-Seropositive Subjects

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