Palate Hyperpigmentation Caused by Prolonged Use of the Anti-Malarial Chloroquine

Filho, Mário Rodrigues de Melo; Silva, Célsia Adriane Dias da; Dourado, Maurício da Rocha; Pires, María da Natividade; Pêgo, Sabina Pena Borges; Freitas, Edmilson Martins De

doi:10.1007/s12105-011-0288-5

Cited by 26 publications

(36 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Oral pigmentation caused by antimalarial drugs was reported for the first time in 1945 by soldiers who were in the South Pacific and had been treated with quinacrine hydrochloride 11 . Several subsequent clinical case reports were published reporting oral pigmentation induced by continuous use of antimalarial drugs, such as hydroxychloroquine sulfate and chloroquine diphosphate [4][5][6][7][8] .…”

Section: Discussionmentioning

confidence: 99%

“…The pigmentation of the oral mucosa caused by antimalarial drugs is usually asymptomatic, colored blue and gray, and exhibit a remarkable demarcation between the soft and hard palate. Even though the palatal mucosa is the site with greatest occurrence, the literature does not provide a plausible explanation for the appearance of pigmentation mainly in this region [4][5][6][7][8] . Often, this drug-induced pigmentation is more blackened and exhibits irregular edges, whose aspect is similar to that of melanomas 12 .…”

Section: Discussionmentioning

confidence: 99%

“…Individuals who require continuous use of this drug may exhibit pathological pigmentation of the face, upper and lower limbs, and also some mucous membranes, such as the oral mucosa. These are changes that evolve from isolated macules to major lesions that can appear on the lips and, mainly, in the palate [4][5][6][7][8] . In addition, patients may develop irreversible retinal damage 9,10 .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pathological pigmentation of the skin and palate caused by continuous use of chloroquine

Ferrazzo¹,

Payeras²,

Surkamp³

et al. 2017

J Oral Diag

View full text Add to dashboard Cite

Introduction: Chloroquine diphosphate is an antimalarial drug commonly used in the treatment of autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis. Chronic use of this drug may cause toxicity and lead to irreversible visual loss. Objective: To report a case of pathological pigmentation of the skin and oral mucosa caused by the use of chloroquine diphosphate. Case report: A 40-year-old female patient used daily doses of chloroquine (250 mg) to treat rheumatoid arthritis. After using this antimalarial drug for two years, the patient exhibited pathological pigmentations in the hard palate and skin of the lower limbs. To prevent retinal damage, given the toxicity observed in the skin and mucous membranes, the medical team replaced this antimalarial drug. Conclusion: Pathological pigmentation is a sign of drug toxicity and may serve as a warning for health professionals in order to prevent macular diseases caused by antimalarial agents. We emphasize the importance of dental surgeons for the differential diagnosis of pathological pigmentation of the oral mucosa, as well as the importance of multidisciplinary work involving other health sectors to prevent the onset or worsening of clinical problems in these patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pathological pigmentation of the skin and palate caused by continuous use of chloroquine

Ferrazzo¹,

Payeras²,

Surkamp³

et al. 2017

J Oral Diag

View full text Add to dashboard Cite

show abstract

“…La pigmentation, allant du gris bleuté au noirâtre, se traduit par des macules de couleur assez homogène, à limites irrégulières, uniques ou multiples, plus ou moins étendues ; elle peut intéresser la peau, le lit unguéal et la muqueuse buccale. Dans la cavité buccale, la pigmentation siège le plus souvent sur la fibro-muqueuse palatine [1,2,[4][5][6][7] -les premiers cas de pigmentation palatine dus aux antipaludéens (quinacrine) ont été rapportés en 1945 chez 156 soldats américains stationnés dans le Pacifique Sud [in 5, in 6] -, plus rarement la gencive, les joues, la langue ou les lèvres. La pigmentation est due à la présence de mélanine [7] ou d'hémosidérine dans le chorion, les deux étant le plus souvent associées [3,5,6].…”

Section: Commentairesunclassified

Pigmentation palatine due à la chloroquine persistant après plus de 50 ans ?

Martinelli-Kläy¹,

Lombardi²,

Samson

2012

Med Buccale Chir Buccale

View full text Add to dashboard Cite

Mots clés : pigmentation muqueuse / chloroquine / palaisKey words: mucosal pigmentation / chloroquine / palate Résumé -Les antipaludéens de synthèse de référence -la chloroquine et l'hydroxychloroquine -ont vu leurs indications s'élargir après la découverte de leurs propriétés antiinflammatoires et immuno-modulatrices. Ils sont fréquemment utilisés pour le traitement de certaines affections dermatologiques et rhumatologiques. Ils sont le plus souvent bien tolérés mais ils comportent des effets indésirables, en particulier cutanéo-muqueux qui se traduisent principalement par une pigmentation gris bleuté ou noirâtre. Cette pigmentation peut intéresser la peau, le lit unguéal et la muqueuse buccale, le plus souvent la fibro-muqueuse palatine. Elle résulte d'une stimulation de la mélanogenèse et d'une accumulation de mélanine dans le derme ou le chorion, parfois associée à des dépôts d'hémosidérine. Normalement, la pigmentation régresse en quelques mois après l'arrêt du traitement. Nous rapportons un cas où la pigmentation palatine semble persister plus de 50 ans après l'arrêt du traitement.Abstract -Chloroquine-induced pigmentation of the hard palate persisting for more than 50 years ? Synthetic antimalarials -chloroquine and hydroxychloroquine -are now more largely prescribed to treat dermatological and rhumatological diseases because of their anti-inflammatory and immuno-modulatory activities. Usually well tolerated they may be responsible of multiple undesirable side effects affecting particularly skin and mucosae. The most frequent of these is a blue-grey or blackish pigmentation of the skin, the nail bed and the oral mucosa, more commonly the palatal fibromucosa. This pigmentation is considered to be the result of a melanogenic stimulation and accumulation of melanin in the dermis or chorion, sometimes associated with ferric iron. Usually the pigmentation regresses some months after the discontinuation of the antimalarial drug. We report an unusual case of palatal pigmentation that seemed apparently to persist for more than 50 years after chloroquine discontinuation. (Fig. 1). Devant cette lésion isolée et l'absence de renseignements précis, plusieurs diagnostics ont Un patient âgé de 66 ans est venu consulter en

show abstract

“…Pigmentary changes in the oral mucosa may be caused by many medications, including antimalarial drugs (chloroquine phosphate, hydroxychloroquine, quinidine and quinacrine), tranquilizers (chlorpromazine), chemotherapeutic drugs (doxorubicin, busulfan and cyclophosphamide), antiretroviral agents (AZT and ketoconazole), antibiotics (minocycline) and laxatives (phenolphthalein). 1 The pathogenesis underlying drug pigmentation can be categorized as arising from the deposition of metabolites or drugs in the dermis and epidermis, melanin deposition with or without melanocyte augmentation and drug-induced post-inflammatory mucosal changes. 2 Chloroquine phosphate, classified as an antimalarial agent due to its immunosuppressive potential and anti-inflammatory action, is also used for the treatment systemic lupus erythematosus and rheumatoid arthritis, in addition to other dermatological conditions.…”

Section: Introductionmentioning

confidence: 99%

Extensive hard palate hyperpigmentation associated with chloroquine use

Godinho¹,

Paz²,

Gomes

et al. 2020

Brit J Clinical Pharma

View full text Add to dashboard Cite

A 66‐year‐old woman diagnosed clinical manifestation of extensive hard palate hyperpigmentation is presented. Due to historic of rheumatoid arthritis and use of chloroquine phosphate for 3 years, exogenous hyperpigmentation associated with the drug was included among the possible diagnoses. Incisional biopsy was performed and the histopathological exam confirmed exogenous hyperpigmentation compatible with chloroquine use. The patient was referred to the rheumatologist and the ophthalmologist for evaluation of the continuity of the chloroquine use. After one year of follow‐up, no changes were seen in the hyperpigmentation nor other clinical changes. Hyperpigmentation of the hard palate by the use of chloroquine is one of the adverse effects of the chronic use of this drug and does not require specific treatment. The adequate anamnesis and the knowledge about the adverse effects of the drug allowed an adequate therapeutic approach in the case.

show abstract

Palate Hyperpigmentation Caused by Prolonged Use of the Anti-Malarial Chloroquine

Cited by 26 publications

References 9 publications

Pathological pigmentation of the skin and palate caused by continuous use of chloroquine

Pathological pigmentation of the skin and palate caused by continuous use of chloroquine

Pigmentation palatine due à la chloroquine persistant après plus de 50 ans ?

Extensive hard palate hyperpigmentation associated with chloroquine use

Contact Info

Product

Resources

About