Oral Pigmentations in HIV Patient with
Co-infections on Antiretroviral Therapy

Dwi Kartika Sari1, Febrina Rahmayanti2, Endah Ayu Tri Wulandari3

Oral Medicine Residency Program, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia

Departement of Oral Medicine, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia

Division of Oral Medicine, Departement of Dentistry, Dr. Cipto Mangunkusumo General Hospital/Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia




Background: Oral pigmentation is described as an oral lesion that is less associated with HIV/AIDS but quite often found. It can appear on any part of the oral mucosa, asymptomatic, with variable colour, shape and size.


Objective: A case study to describe oral pigmentation and explore its possible aetiologies in HIV patients with co-infections on ART.


Case report: A 58-year-old female patient was referred from the Dermatovenereology Clinic to Oral Medicine Clinic, Dr. Cipto Mangunkusumo General Hospital with BT type morbus hansen and recurrent reversal reaction, syphilis, HIV and dental caries. The laboratory results a showed reactive IgG anti-Herpes simplex virus type-2, and absolute CD4 count was 125 cells/µL. Intra oral examination showed extensive  diffuse pigmentation on the right and left buccal mucosa, lower labial mucosa, left commissure, left dorsolateral tongue, and hard palate. We also found a few dental radices, tooth mobility and cavities. The patient was referred to Integrated HIV Clinic due to her systemic conditions.


Conclusion: Oral pigmentation in HIV/AIDS can be related to low absolute CD4 count (below 200 cells/µL), antiretroviral therapy or adrenocortical insufficiency due to co- infection. Dental practitioners need to be abe to recognise and understand the possible aetiologies of oral pigmentation in HIV/AIDS patient.


Keywords: Oral pigmentation, HIV, Co-infections