{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T09:31:59Z","timestamp":1787391119824,"version":"build-2736575974"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005639","name":"Universidade De S\u00e3o Paulo","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005639","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Head and Neck Pathol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12105-026-01954-8","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T06:28:51Z","timestamp":1784874531000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Lenalidomide-Associated Oral Pigmentation: A Case Report"],"prefix":"10.1007","volume":"20","author":[{"given":"Andr\u00e9 Luis Santana","family":"de Freitas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana Gomes Cardoso Pereira","family":"de Sousa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cleverson Teixeira","family":"Soares","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosane Rezende","family":"de Souza Giuliani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andresa Borges","family":"Soares","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"issue":"9","key":"1954_CR1","doi-asserted-by":"publisher","first-page":"1802","DOI":"10.1002\/ajh.27422","volume":"99","author":"SV Rajkumar","year":"2024","unstructured":"Rajkumar SV (2024) Multiple myeloma: 2024 update on diagnosis, risk-stratification, and management. Am J Hematol 99(9):1802\u20131824. https:\/\/doi.org\/10.1002\/ajh.27422","journal-title":"Am J Hematol"},{"issue":"9","key":"1954_CR2","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1038\/s41571-025-01041-x","volume":"22","author":"MA Dimopoulos","year":"2025","unstructured":"Dimopoulos MA, Terpos E, Boccadoro M, Moreau P, Mateos MV, Zweegman S, Cook G, Engelhardt M, Delforge M, Hajek R, Schjesvold F, Gay F, Manier S, Weisel KC, Kaiser M, van de Donk NWCJ, Zamagni E, Rodriguez-Otero P, Perrot A, Driessen C, Sonneveld P (2025) EHA-EMN evidence-based guidelines for diagnosis, treatment and follow-up of patients with multiple myeloma. 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