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Oral Pigmentation Resulting from Pharmacological Treatment in Patient with Chronic Hepatitis C

만성 C형 간염의 약물 치료와 연관된 구강 내 색소 침착의 치험례

  • Kim, Young Gun (Department of Orofacial Pain and Oral Medicine, Yonsei Dental Hospital, Yonsei University College of Dentistry) ;
  • Ahn, Hyung-Joon (Department of Orofacial Pain and Oral Medicine, Yonsei Dental Hospital, Yonsei University College of Dentistry) ;
  • Choi, Jong-Hoon (Department of Orofacial Pain and Oral Medicine, Yonsei Dental Hospital, Yonsei University College of Dentistry) ;
  • Kwon, Jeong-Seung (Department of Orofacial Pain and Oral Medicine, Yonsei Dental Hospital, Yonsei University College of Dentistry)
  • 김영건 (연세대학교 치과대학 구강내과학교실) ;
  • 안형준 (연세대학교 치과대학 구강내과학교실) ;
  • 최종훈 (연세대학교 치과대학 구강내과학교실) ;
  • 권정승 (연세대학교 치과대학 구강내과학교실)
  • Received : 2012.08.24
  • Accepted : 2012.10.28
  • Published : 2012.12.30

Abstract

Oral pigmentation has numerous etiologies. It can be associated with congenital diseases and syndromes, certain acquired diseases, and systemic medications. Pigmented lesions caused by serious disease such as melanoma should be diagnosed correctly, because it would be fatal. For appropriate differential diagnosis, clinicians should know about the etiologies causing oral pigmentation and take patients history carefully. Biopsies would be necessary for histopathological findings. Close follow up for clinical symptoms are also necessary. In this case report, we presented a case of oral hyperpigmentation in Asian patient who was receiving pegylated interferon and ribavirin combination therapy for hepatitis C virus infection.

구강내의 다발성 색소침착은 애디슨증후군, 포이츠-예거 증후군과 같은 선천성질환에 의하여 유발되거나, 악성 흑색종, 흑색극세포종, 신경섬유종증과 같은 국소적인 질환, 흡연, 만성 외상, 약물 복용 등에 의해서 유발될 수 있다. 이러한 질환 중 악성흑색종과 같은 질환은 생명을 위협할 수 있는 질환이므로 구강 내 색소 침착이 발견될 경우 정확한 진단이 필수적이다. 이러한 병소의 정확한 감별 진단을 위해서는 구강 내 색소 침착을 유발할 수 있는 원인에 대해서 숙지하고 있어야 하며, 상세한 병력 청취가 중요하다. 또한, 필요 시 혈액검사를 비롯한 이화학검사를 시행하거나 생검을 통하여 조직병리학적인 소견을 확인하고, 주기적으로 환자의 임상 소견에 대한 평가를 시행하여 변화를 확인하여야 한다. 그 동안 일반적으로 색소 침착을 유발하는 것으로 알려졌던 약물 외에, 만성 C형 간염 환자에서 페그인터페론 알파와 리바비린의 병용 요법 중 발생한 구강 내 다발성 색소 침착 증례가 있어 문헌 상에 보고되었던 만성 C형 간염 환자의 약물치료와 연관된 구강 내 색소 침착의 증례들과 함께 고찰해 보고자 한다.

Keywords

References

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