Chapter 032. Oral Manifestations of Disease (Part 4)

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Pigmented Lesions See Table 32-2. Table 32-2 Pigmented Lesions of the Oral Mucosa Condition Usual Location Clinical Features Course Oral melanotic macule Any area of the mouth diffuse Discrete or Remains no localized, indefinitely; brown to black macule growth Diffuse melanin pigmentation Any area of the mouth Diffuse pale to dark-brown pigmentation; may be physiologic ("racial") Remains indefinitely or due to smoking Nevi Any area of the mouth Discrete, localized, brown Remains to indefinitely black pigmentation Malignant melanoma Any area of the mouth Can be flat and diffuse, Expands and early; painless, invades brown to black, or can metastasis leads to be raised and nodular death Addison's disease of but Any area the Blotches or Condition by steroid ...

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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 Remains melanotic macule of the mouth diffuse localized, indefinitely; no
brown to black macule growth Diffuse Any area Diffuse pale to Remains melanin of the mouth dark-brown indefinitely pigmentation 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 and melanoma of the mouth diffuse, painless, invades early; brown to black, or can metastasis leads to be raised and nodular death Addison's Any area Blotches or Condition disease 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 Oral Jeghers 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, Gradually ingestion of the mouth or gray areas of disappears following (neuroleptics, oral pigmentation cessation of drug contraceptives,
minocycline, zidovudine, quinine derivatives) Amalgam Gingiva Small blue- Remains tattoo 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 of pigmentation margin pigmented line along systemic absorption; (bismuth, mercury, gingival margin; rarely no significance for lead) seen except for oral health children exposed to lead-based paint
Black hairy Dorsum Elongation of Improves tongue 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 antibiotic if due to bacterial overgrowth Fordyce Buccal Numerous small Benign; "spots" and labial yellowish spots just remains without mucosa beneath mucosal apparent change surface; no symptoms; due to hyperplasia of sebaceous glands Kaposi's Palate Red or blue Usually sarcoma most common, plaques of variable size indicative of HIV but may occur in and shape; often infection or non- any other site enlarge, become Hodgkin's nodular and may lymphoma; rarely fatal, but may
ulcerate require treatment for comfort or cosmesis Mucous Buccal Bluish-clear Benign; retention cysts and labial fluid-filled cyst due to painless unless mucosa extravasated mucous traumatized; may be from injured minor removed surgically salivary gland