Melanin Pigmentation, Women, and Levodopa

To the Editor. —  In the November 1977 issue of the Archives (113:1533-1538), C. Anders Hedin, DDS, found that women constituted a high proportion of subjects with gingival melanosis due to tobacco smoking, even though these women had a lower cigarette consumption than the affected men.This female preponderance has been observed in other instances of hyperpigmentation, such as that induced by hydantoin anticonvulsants.¹ In a survey of 70 patients with chlorpromazine melanosis, all were female.² A reflectance spectrophotometry study of subjects under prolonged therapy with phenothiazines and/or hydantoins showed that women (both white and black) had a strikingly greater pigmentary response to these drugs than did their male counterparts.³ A comparison of blue-eyed and brown-eyed whites revealed that only the women tended toward a skin melanin difference in the expected direction.⁴As levodopa is a precursor of melanin, I recently conducted a small pilot study