HIV-Associated Oral Mucosal Melanin Hyperpigmentation: A Clinical Study in a South African Population Sample

Figure 1

Clinical illustration of HIV-OMH. (a) Melanin hyperpigmentation of the floor of the mouth of a female 42-year-old nonsmoker who was HIV-seropositive with a CD4+ T cell count of 25 cells/mm³. She had been diagnosed with HIV disease 3 years previously. Highly active antiretroviral therapy (HAART) was started immediately after the diagnosis, and the hyperpigmentation appeared some time later. (b) Irregular, nonhomogeneous pigmented patch on the buccal mucosa of a 69-year-old HIV-seropositive male with a CD4+ T cell count of 88 cells/mm³. He had been diagnosed with HIV infection seven years previously. HAART was started after 2 years and the hyperpigmentation appeared 4 years later. The patient is a nonsmoker. (c) Multiple, pigmented maculae on the maxillary gingiva and labial mucosa of a 40-year-old HIV-seropositive male with a CD4+ T cell count of 141 cells/mm³. He had been diagnosed with HIV disease 10 years previously and HAART was started immediately. The hyperpigmentation appeared two years later. (d) Multiple pigmented maculae of the dorsum of the tongue in a 32-year-old HIV-seropositive male on HAART with a CD4+ T cell count of 422 cells/mm³. He had been found to be HIV-seropositive eight years previously and HAART was started a year later. The patient recalls that the hyperpigmentation developed after the start of HAART medication but he is unsure exactly when it appeared. None of the patients whose oral pigmentation is illustrated had any other oral soft tissue abnormalities or any known systemic disease.

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