Oral hyperpigmentation in HIV-infected patients

Area of Science:

• Oral Medicine
• Dermatology
• Infectious Diseases

Background:

• Oral hyperpigmentation is an uncommon finding in patients with Human Immunodeficiency Virus (HIV) infection.
• Potential causes include iatrogenic factors, such as systemic medications, or idiopathic origins.
• Understanding the clinical and histological features is crucial for diagnosis and management.

Purpose of the Study:

• To report and characterize six cases of oral hyperpigmentation in HIV-infected individuals.
• To investigate the potential etiologies, including medication side effects and unknown causes.
• To describe the clinical presentation and histological findings of these lesions.

Main Methods:

• Case series reporting six HIV-infected patients with oral hyperpigmentation.
• Clinical examination of oral mucosa, gingiva, palate, and tongue.
• Histopathological analysis of biopsied pigmented lesions.
• Review of patient medication history.

Main Results:

• Two cases were associated with systemic clofazimine or ketoconazole therapy.
• In four cases, the etiology of hyperpigmentation remained unknown.
• Clinical findings included sudden-onset, well-defined brown-black macules on various oral sites.
• One patient exhibited hyperpigmented nail striations.
• Histology showed melanin accumulation in phagocytes/extracellularly for drug-related cases, and basal cell layer/extracellular foci for unknown causes.

Conclusions:

• Oral hyperpigmentation in HIV patients can be drug-induced or idiopathic.
• Clinical and histological examination aids in differentiating causes.
• Further investigation may be needed for idiopathic cases to rule out other underlying conditions.