Chemotherapy Induced Lingual Hyperpigmentation

Patients receiving chemotherapy experience a variety of side effects in the oral cavity. Fortunately, most of them are short-term. One long-term side effect which has been reported due to chemotherapy is oral hyperpigmentation. This is challenging to diagnose due to a variety of conditions having similar clinical appearance. It can easily be misdiagnosed as racial pigmentation which is far more common. In this case report we will describe a 58-year-old African American female experiencing localized gum bleeding during brushing. She mentioned during the appointment that she also would like to get the hyperpigmentation on the dorsal surface of her tongue evaluated. The diagnosis of drug-induced pigmentary changes is based on correlating the onset of clinical appearance of pigmentation with initiation of chemotherapeutic drug use. The mechanism of chemotherapy-related oral hyperpigmentation remains unknown. However, lesion size measurements and photographs can be documented and tracked over time to rule out the possibility of melanoma. Patients should be made aware that oral hyperpigmentation due to chemotherapy is a benign condition.

Keywords: Hyperpigmentation; Chemotherapy; Oral; Tongue; Cyclophosphamide