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

Abstract

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.

Oral Manifestations of Chloroquine and Hydroxychloroquine: Differential Diagnoses

“…Interruption of the use of the medication [5] [10] [11] [12] followed. However, there were cases in which drug substitution [13] occurred and the injury was monitored [14].…”

Hiperpigmentação em mucosa oral de pacientes usuários de cloroquina e hidroxicloroquina: Revisão de literatura

“…Os antimaláricos são um dos medicamentos mais conhecidos por apresentarem pigmentação da mucosa oral como efeito adverso naqueles indivíduos que necessitam de uso contínuo (Ferrazzo, Payeras, Surkamp & Danesi, 2017). A pigmentação da mucosa oral pode ter diversas etiologias e envolver uma variedade imensa de lesões e condições.…”

Prevalence and risk factors of hyperpigmentation induced by hydroxychloroquine in lupus patients

“…These mucocutaneous hyperpigmentation were thought to be dose-dependent. 7 Only a few cases of hyperpigmentation attributed to HCQ have been reported in the literature from different geographical areas. [8][9][10][11] To our knowledge, no case reports or local studies from Saudi Arabia estimated the magnitude of HCQ adverse effect.…”