Tongue Hyperpigmentation Associated with Temozolomide as a Single Agent: Case Report

Area of Science:

• Oncology
• Dermatology
• Pharmacology

Background:

• Tongue hyperpigmentation is a known side effect of certain cytotoxic chemotherapy drugs.
• The precise pathophysiological mechanisms underlying chemotherapy-induced oral pigmentary changes remain unclear.

Observation:

• A 37-year-old Black woman developed tongue hyperpigmentation one week after starting single-agent temozolomide chemotherapy.
• This represents the first reported instance of tongue hyperpigmentation specifically linked to temozolomide monotherapy.

Findings:

• The diagnosis of drug-associated pigmentary changes relies on the temporal relationship between drug initiation and symptom onset.
• Chemotherapy-induced tongue hyperpigmentation is generally a self-limiting condition.

Implications:

• This case underscores the importance of reporting rare adverse drug events to improve clinical management.
• Healthcare providers need to be aware of potential side effects like temozolomide-induced tongue hyperpigmentation to manage patient expectations and provide appropriate care.