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Special site melanoma (mucosal, acral)
Published in Longo Caterina, Diagnosing the Less Common Skin Tumors, 2019
Oral melanomas usually present on the hard palate, maxillary gingiva and lips. Most patients are in the seventh decade. The clinical presentation of tumors is variable, from macular to ulcerated and nodular painless mass, often bleeding. The colors vary from black to gray to purple to red to white, and they can be variably arranged. Pigmented lesions from 1 to 10 mm or larger can be found, and reports of previously existing pigmented lesions are common. Amelanotic melanoma cases are also reported, and in these cases a misdiagnosis is frequent. The differential diagnosis for intraoral melanotic lesions includes mucosal melanoma, amalgam tattoo, melanotic macule, oral mucosal nevi and melanoacanthoma.
Benign Oral and Dental Disease
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Konrad S. Staines, Alexander Crighton
Isolated or localized pigmentation can also be caused by any of the systemic causes for pigmentation; the observer may simply be seeing the start of the process. Localized lesions tend to have a local cause such as an amalgam tattoo where a tooth apicectomy has been performed, or post-inflammatory pigmentation in an area of trauma. However, the commonest cause is the simple melanotic macule or freckle but this should be confirmed on biopsy to differentiate it from a naevus or early dysplastic change. Peutz–Jeghers syndrome is an autosomal dominant trait characterized by hamartomatous intestinal polyposis and multiple areas of mucocutaneous melanotic perioral pigmentation.
Q-switched 532 nm Nd:YAG laser therapy for physiological lip hyperpigmentation: novel classification, efficacy, and safety
Published in Journal of Dermatological Treatment, 2022
Saad Altalhab, Mohammed Aljamal, Thamer Mubki, Naief AlNomair, Shoug Algoblan, Ammar Alalola, Mohammed I. AlJasser, Ahmed Alissa
Labial hyperpigmentation can be focal, or diffuse. Examples of focal lip hyperpigmentation include labial melanotic macule, melanocytic nevi, and amalgam tattoo (1,8). Several conditions are known to be associated with multiple hyperpigmented lesions or diffuse lip hyperpigmentation. Those include physiological hyperpigmentation (2), smoking (9), Peutz–Jeghers syndrome (PJS) (2), Laugier–Hunziker syndrome (LHS) (10), atopic dermatitis (11), post-inflammatory hyperpigmentation (12), Addison disease (13), and some medications (14). Of those, PLH and smoker’s melanosis appears to be the most common (15). Despite that, it is important to rule out any systemic causes, especially if there are any associated systemic symptoms. Lack of screening of these diseases may represent an important confounder and may affect our results. Also, it is important to rule out melanoma, particularly in skin type I to III.
Treatment of gingival pigmentation with a 755-nm alexandrite picosecond laser
Published in Journal of Cosmetic and Laser Therapy, 2020
Cristina Pindado-Ortega, Adrián Alegre-Sánchez, Aitana Robledo-Sánchez, Ignacio Tormo-Alfaro, Pablo Boixeda
Gingival pigmentation can be produced by increased biosynthesis and deposition of melanin, increased number of melanocytes (melanocytosis) or deposition of exogenous materials. Hence, a meticulous personal history of the patient is essential in determining whether the oral pigmentation cause is physiological or pathological. Among the etiological factors reported are endocrine disorders such as Addison’s disease, Albright and Nelson’s syndrome or acromegaly, malignant melanoma, Kaposi’s sarcoma, Peutz Jeghers syndrome, Laugier-Hunziker syndrome, hemochromatosis, chronic pulmonary disease, exposure to UV rays, trauma, drugs, tobacco, heavy metal ingestion, amalgam tattoo and genetics(1).