Drug Associated Oral Pigmentation

Gingival pigmentation due to heavy metals such as mercury, lead, bismuth, arsenic and others was not rare in the past due to industrial exposure and in some cases therapeutic administration, particularly for the treatment of syphilis. They caused blue, brown or black lines close to the gingival margins due to the deposition of sulphides as a result of reactions with products of the dental plaque. A wide range of drugs can cause more generalised oral pigmentation including antimalarials, phenothiazines and some contraceptive pills [98]. Drugs used in the treatment of HIV infection such as zidovudine and some antifungals such as ketoconazole have also been shown to cause oral pigmentation.

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