pigmented lesions of the oral mucosa

Etiology: 1) oral melanocytic macule a) any area of mouth b) discrete or diffuse, brown to black macules c) remains indefinitely 2) diffuse melanin pigmentation a) any area of mouth b) may be physiologic or due to smoking c) remains indefinitely 3) melanocytic nevus a) any area of mouth b) discrete, localized, brown to black c) remains indefinitely 4) malignant melanoma a) any area of mouth b) variable morphology, brown to black, may be painless c) expands & invades early; metastasis leads to death 5) Addison's disease a) generally on buccal mucosa b) blotches of blueish-black to dark brown pigmentation; diffuse pigmentation of skin c) lesions response to steroid therapy 6) Peutz-Jeghers syndrome a) any area of mouth b) dark brown spots on lips & buccal mucosa; pigment around lips, nose, eyes, & on hands c) pigmented lesions remain indefinitely 7) drug ingestion a) tranquilizers, oral contraceptives, antimalarials b) any area of mouth c) brown, black or gray areas of pigmentation d) lesions disappear with cessation of drug 8) amalgam tattoo a) gingiva & mucobuccal fold b) small blue-black pigmented areas associated with embedded amalgam; may appear as radiopaque particles c) remains indefinitely 9) heavy metal pigmentation a) bismuth, lead, mercury b) thin blue-black pigment line along gingival margin c) due to prior treatment with bismuth or mercury or lead exposure d) long duration of lesions 10) black hairy tongue a) dorsum of tongue b) elongation of filiform papillae of tongue; brown to black c) long duration; may disappear spontaneously 11) Fordyce's disease (spot) a) buccal & labial mucosa b) aggregation of numerous small yellow spots just beneath the buccal mucosa; no symptoms c) remains indefinitely

Specific

Addison's disease (primary adrenal failure) Fordyce spot (granule) melanocytic nevus (mole) melanoma Peutz-Jeghers syndrome (hamartomatous intestinal polyposis)

General

pigmented lesion mouth lesions, mucosa (oral lesion)

References

Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 203