Reactions 1453 - 25 May 2013

Peginterferon-α-2a/ribavirin

Tongue hyperpigmentation: case reportA 43-year-old man developed tongue hyperpigmentation

during treatment for chronic hepatitis C infection withpeginterferon-α-2a [Pegasys] and ribavirin [Copegus].

The man received a combination of peginterferon-α-2a180µg once weekly and ribavirin 1200mg daily for two6-month cycles with a 1-month break between cycles [routesnot stated]. Four weeks after starting the treatment, hepresented with oral discomfort and pigmentation changes onhis tongue. His symptoms continued to worsen, and there waslittle improvement during the break between cycles. Physicalexamination showed bluish and reticular patches ofhyperpigmentation on his tongue. A tongue biopsy revealedhyperpigmentation of the epidermal basal layer, and there waspositive immunohistochemical staining for both HMB45 andmelanA.

The pigmentation started to disappear 4 months after theend of the man’s therapy.

Author comment: "[T]he temporal relationship betweenthe initiation of [hepatitis C virus] therapy and the observedpigmentary change made us speculate that antiviral therapyinduced this abnormality."Mlika RB, et al. Tongue hyperpigmentation during PEG-interferon-alfa/ribavirintherapy in a non-Caucasian patient with chronic hepatitis C: A case report andreview of the literature. International Journal of Dermatology 52: 643-644, No. 5,May 2013. Available from: URL: http://dx.doi.org/10.1111/j.1365-4632.2011.04921.x - Tunisia 803087046

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Reactions 25 May 2013 No. 14530114-9954/10/1453-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved