Authors
André Luis Santana de Freitas, Fabiana Gomes Cardoso Pereira de Sousa, Cleverson Teixeira Soares, Rosane Rezende de Souza Giuliani, Andresa Borges Soares
Published in
Head and neck pathology. Volume 20. Issue 1. Jul 24, 2026. Epub Jul 24, 2026.
Abstract
Lenalidomide is an immunomodulatory agent widely used in the treatment of multiple myeloma and is generally associated with a favorable safety profile. Although pigmentary alterations such as cutaneous hyperpigmentation and hair repigmentation have been reported, oral mucosal involvement remains poorly documented.
An 80-year-old Black female with multiple myeloma undergoing lenalidomide therapy presented with asymptomatic brown macules on the tongue, hard palate, bilateral buccal mucosa and gingiva. Histopathological examination of an incisional biopsy on the tongue revealed many fine granular, brownish pigmentation of approximately the same size throughout all epithelial layers, as well as collagen fibers, vascular walls, neural tissue, and skeletal striated muscle. These findings represent an unusual pattern of pigment distribution not previously described in patients under lenalidomide therapy.
This case emphasizes the need for thorough oral examination in patients undergoing lenalidomide therapy, as early recognition of drug-induced pigmentation is essential for proper diagnosis and management.
PMID:
42496822
Bibliographic data and abstract were imported from PubMed on 24 Jul 2026.
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