Characteristics of IFN or PEG-IFN and RBV-induced tongue and oral mucosa hyperpigmentation

Table 1: Characteristics of IFN or PEG-IFN and RBV-induced tongue and oral mucosa hyperpigmentation

Case	Age	Sex	Skin	HCV	Dosage	Duration**	Hyperpigmentation						Symptom	Outcome	Ref
#			Color	GT*	IFN/RBV	of Tx (M)	Tongue	Gum	HP	BM	Nail	Skin		(M)
1	47	F	Dark	5	IFN 3MU/d; RBV 1,200 mg/d	9	+	-	-	-	+	+	-	Disappear (24)	[2]
2	47	M	Dark	2a	***	12	+	-	-	-	-	+	-	Improved after dose reduction	[2]
3	41	F	Dark	2a	PEG-IFN 180 μg/w; RBV 400 mg/d	?	+	-	-	-	-	+	?	Improved (2)	[3]
4	46	M	Dark	4c	PEG-IFN 180 μg/w; RBV 1,200 mg/d	?	+	-	-	-	-	-	?	Unchanged (6)	[3]
5	49	F	Dark	1b	Same as #4	?	+	-	-	-	-	+	?	Improved (3)	[3]
6	46	M	Dark	1	Same as #4	?	+	-	-	-	-	-	?	Disappeared during treatment	[3]
7	40	M	Dark	4	PEG-IFN 180 μg/w; RBV 1,000 mg/d	?	+	-	-	-	-	+	?	Unchanged	[3]
8	45	M	Dark	3a	PEG-IFN 80 mg/w; RBV 800 mg/d	2	+	-	-	-	-	-	?	Improved (6)	[8]
9	54	F	Dark	1b	?	4	+	-	-	+	-	-	?	Unchanged (6)	[8]
10	53	F	White	?	?	1.5	+	-	+	-	-	-	+	Tx ongoing	[5]
10	53	F	White	?	?	1.5	+	-	+	-	-	-	(Tongue Burning)	Tx ongoing	[5]
11	58	M	Dark	6	Same as #4	2	+	-	-	+	-	+	?	Improved (5)	[9]
12	33	F	Dark	1b	Same as #8	11	+	+	-	-	-	-	?	Gum disappeared (12) Tongue persisted	[10]
13	40	F	White	4	Same as #7	3	+	-	-	+	-	-	+	?	[11]
13	40	F	White	4	Same as #7	3	+	-	-	+	-	-	(Tongue discomfort)	?	[11]
14	66	F	Dark	?	Same as #7	8	+	-	-	-	-	-	-	Reduced (6)	[12]
15	54	F	White	1b	Same as #8	4	+	-	-	-	-	-	-	?	[13]
16	36	F	White	?	PEG-IFN 120 μg/w; RBV 800 mg/d	4	+	-	-	-	-	-	+	?	[14]
16	36	F	White	?	PEG-IFN 120 μg/w; RBV 800 mg/d	4	+	-	-	-	-	-	(Tongue sensitive)	?	[14]
17	54	F	Dark	?	PEG-IFN1.5 μg/kg/w; RBV 1,000 mg/d	2	+	-	-	-	-	-	-	?	[15]
18	44	F	Dark	4	PEG-IFN 80 μg/w; RBV 1,000 mg/d	10.5	+	-	-	-	-	-	+	Reduced (6)	[16]
18	44	F	Dark	4	PEG-IFN 80 μg/w; RBV 1,000 mg/d	10.5	+	-	-	-	-	-	(Tongue discomfort)	Reduced (6)	[16]
19	47	F	Dark	4	?	2	+	-	-	-	-	-	-	?	[17]
20	43	M	Dark	1b	Same as #4	1	+	-	-	-	-	-	+	Disappeared (4)	[18]
20	43	M	Dark	1b	Same as #4	1	+	-	-	-	-	-	(Oral discomfort)	Disappeared (4)	[18]
21-27	28-66	M, F	****	?	?	?	*****								[4]
28	47	M	White	?	?	11	+	-	-	-	-	-	?	Disappeared (3)	[19]
29	49	F	White	1	PEG-IFN 180 μg/w; RBV 1000 mg/d	1	+	-	-	+	-	-	+	Tx ongoing	[20]
29	49	F	White	1	PEG-IFN 180 μg/w; RBV 1000 mg/d	1	+	-	-	+	-	-	(Tongue Burning)	Tx ongoing	[20]
30	63	F	White	?	?	6	+	-	-	+	-	-	?	Improved (14)	[21]

* Abbreviations and Acronyms used: BM, buccal mucosa; d, day; F, female; HCV GT, hepatitis C virus genotype; HP, hard palate; IFN, interferon; M, male; (M), month; MU, million units; PEG-IFN, polyethylene glycol-conjugated IFN; RBV, ribavirin; Tx, treatment; w, week; ?, information not available.

** Duration of treatment in months when hyperpigmentation was noted.

*** IFN: 10 MU/d x 2w, 5 MU/d x 2w, 3 MU/d x 11m, 3 MU 3x/w x 6m; RBV: 1,200 mg/d x 7m, 800 mg/d x 11m.

**** Skin colour (Fitzpatrick Scale): 2 Type II, 3 Type III, and 2 Type IV.

***** Seven patients with oral hyperpigmentation involving tongue, hard palate, and/or buccal mucosa; only one patient had symptom (tongue discomfort). Of these seven patients, four also had melanonychia.