title: Hard palate hyperpigmentation secondary to chronic chloroquine therapy: report of five cases.
abstract: Antimalarials are commonly prescribed in medical practice for conditions such as rheumatoid arthritis, lupus erythematosus, as well as malaria. They are generally well-tolerated, but side effects, although infrequent, are well known. The antimalarial chloroquine diphosphate may be associated with a bluish-gray to black hyperpigmentation of the oral mucosa, mainly on the hard palate. In this report we described five additional cases of palate hyperpigmentation related to the chronic use of chloroquine diphosphate. Professionals must be aware of the adverse effects of antimalarials as chloroquine diphosphate in order to make the correct diagnosis and appropriate management of the patient. Early diagnosis of oral pigmentation by antimalarials may be of great relevance, because it might be an early sign of ocular involvement, and therefore it may be helpful to prevent further complications of antimalarial therapy for the patient.
authors.affiliation: Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas UNICAMP, Piracicaba, São Paulo, Brazil. augustodelima33@hotmail.com
authors.forename: Bruno Augusto Benevenuto
authors.initials: BA
authors.lastname: de Andrade
authors.forename: Felipe Paiva
authors.initials: FP
authors.lastname: Fonseca
authors.forename: Fábio Ramôa
authors.initials: FR
authors.lastname: Pires
authors.forename: Ana Terezinha Marques
authors.initials: AT
authors.lastname: Mesquita
authors.forename: Saulo Gabriel Moreira
authors.initials: SG
authors.lastname: Falci
authors.forename: Alan Roger
authors.initials: AR
authors.lastname: Dos Santos Silva
authors.forename: Pablo Agustin
authors.initials: PA
authors.lastname: Vargas
authors.forename: Jacks
authors.initials: J
authors.lastname: Jorge
authors.forename: Oslei Paes
authors.initials: OP
authors.lastname: de Almeida
mesh_terms: D000369:Aged, 80 and over; D000962:Antimalarials / Q000008:administration & dosage / Q000009:adverse effects*; D002738:Chloroquine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced / Q000473:pathology; D008297:Male; D008875:Middle Aged; D021362:Palate, Hard / Q000473:pathology*
chemical_list: D000962:Antimalarials; D002738:Chloroquine
keywords: adverse reaction; antimalarial; chloroquine; hard palate; hyperpigmentation