title: Tongue hyperpigmentation resulting from peginterferon alfa and ribavirin combination therapy: a case report.
abstract: BACKGROUND
  Tongue hyperpigmentation is a rare side effect in patients with hepatitis C virus infection who are receiving peginterferon alfa and ribavirin combination therapy. Tongue hyperpigmentation usually occurs after the patient has undergone several months of treatment, and it resolves after the patient discontinues therapy.
  
  
  METHODS
  A 66-year-old dark-skinned woman with hepatitis C virus infection was referred to the Oral Diseases Treatment Center of São Leopoldo Mandic Dental School, Campinas, Brazil, for evaluation of tongue pigmentation after receiving peginterferon alfa and ribavirin combination therapy for 32 weeks. A physical examination showed dark brown, asymptomatic pigmentation in the dorsum of the tongue. Six months after the patient discontinued therapy, the authors observed a marked reduction in the pigmentation's intensity.
  Dentists should be aware that hyperpigmentation of the tongue can result from peginterferon alfa and ribavirin combination therapy. A biopsy should be performed if no firm diagnosis can be obtained from clinical findings and the patient's medical history.
authors.affiliation: São Leopoldo Mandic Dental School, Campinas, Brazil.
authors.forename: Paulo Camargo
authors.initials: PC
authors.lastname: de Moraes
authors.forename: Cesar Werneck
authors.initials: CW
authors.lastname: Noce
authors.forename: Luis Alexandre
authors.initials: LA
authors.lastname: Thomaz
authors.forename: Mário Cláudio
authors.initials: MC
authors.lastname: Mautoni
authors.forename: Maria Elvira Pizzigatti
authors.initials: ME
authors.lastname: Corrêa
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects*; D001938:Brazil; D003937:Diagnosis, Differential; D004338:Drug Combinations; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced* / Q000175:diagnosis; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects; D011092:Polyethylene Glycols / Q000009:adverse effects; D011994:Recombinant Proteins; D012254:Ribavirin / Q000009:adverse effects*; D012880:Skin Pigmentation; D014060:Tongue Diseases / Q000139:chemically induced* / Q000175:diagnosis
chemical_list: D000998:Antiviral Agents; D004338:Drug Combinations; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a