A patient taking chloroquine or hydroxychloroquine for prolonged periods may develop a hyperpigmentation of the hard palate.
Clinicalfeatures:
(1) history of a rheumatic disorder, malaria or other conditions with long-term therapy with chloroquine or hydroxychloroquine
(2) hyperpigmentation of the hard palate, which may be bluish, grey or black
(3) exclusion of other diagnoses
(4) reverses if the medication is stopped
(5) hyperpigmentation of the skin may be present
Pathologic findings in a palate biopsy:
(1) biopsy shows pigment deposition in the submucosa
(2) the pigment stains as hemosiderin (iron positive)
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Specialty: Otolaryngology
