Chapter 032. Oral Manifestations of Disease (Part 4)

Pigmented Lesions See Table 32-2.Table 32-2 Pigmented Lesions of the Oral MucosaConditionUsual LocationClinical FeaturesCourseOral melanotic maculeAny area of the mouth diffuseDiscreteorRemains nolocalized, indefinitely;brown to black macule growthDiffuse melanin pigmentationAny area of the mouthDiffuse pale to dark-brown pigmentation; may be physiologic ("racial")Remains indefinitelyor due to smokingNeviAny area of the mouthDiscrete, localized, brownRemains to indefinitelyblack pigmentationMalignant melanomaAny area of the mouthCan be flat and diffuse,Expands and early;painless, invadesbrown to black, or can metastasis leads to be raised and nodular deathAddisons disease of butAny area theBlotchesorCondition by steroid ...
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Chapter 032. Oral Manifestations of Disease (Part 4) Chapter 032. Oral Manifestations of Disease (Part 4) Pigmented Lesions See Table 32-2. Table 32-2 Pigmented Lesions of the Oral Mucosa Condition Usual Clinical Course Location Features Oral Any area Discrete or Remainsmelanotic macule of the mouth diffuse localized, indefinitely; no brown to black macule growth Diffuse Any area Diffuse pale to Remainsmelanin of the mouth dark-brown indefinitelypigmentation pigmentation; may be physiologic (racial) or due to smoking Nevi Any area Discrete, Remains of the mouth localized, brown to indefinitely black pigmentation Malignant Any area Can be flat and Expands andmelanoma of the mouth diffuse, painless, invades early; brown to black, or can metastasis leads to be raised and nodular death Addisons Any area Blotches or Conditiondisease of the mouth, spots of bluish-black to controlled by but mostly dark-brown adrenal steroid buccal mucosa pigmentation occurring replacement early in the disease, accompanied by diffuse pigmentation of skin; other symptoms of adrenal insufficiency Peutz- Any area Dark-brown OralJeghers syndrome of the mouth spots on lips, buccal pigmented lesions mucosa, with remain indefinitely; characteristic gastrointestinal distribution of pigment polyps may become around lips, nose, eyes, malignant and on hands; concomitant intestinal polyposis Drug Any area Brown, black, Graduallyingestion of the mouth or gray areas of disappears following(neuroleptics, oral pigmentation cessation of drugcontraceptives,minocycline,zidovudine, quininederivatives) Amalgam Gingiva Small blue- Remainstattoo and alveolar black pigmented areas indefinitely mucosa associated with embedded amalgam particles in soft tissues; these may show up on radiographs as radiopaque particles in some cases Heavy metal Gingival Thin blue-black Indicative ofpigmentation margin pigmented line along systemic absorption;(bismuth, mercury, gingival margin; rarely no significance forlead) seen except for oral health children exposed to lead-based paint Black hairy Dorsum Elongation of Improvestongue of tongue filiform papillae of within 1–2 weeks tongue, which become with gentle brushing stained by coffee, tea, of tongue or tobacco, or pigmented discontinuation of bacteria antibioti ...