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Review
. 2012 Nov 1;17(6):e919-24.
doi: 10.4317/medoral.17679.

Oral pigmented lesions: Clinicopathologic features and review of the literature

Rogério-Oliveira Gondak  1 , Rogério da Silva-Jorge, Jacks Jorge, Márcio-Ajudarte Lopes, Pablo-Agustin Vargas
Affiliations
Review

Oral pigmented lesions: Clinicopathologic features and review of the literature

Rogério-Oliveira Gondak et al. Med Oral Patol Oral Cir Bucal. .

Abstract

Diagnosis of pigmented lesions of the oral cavity and perioral tissues is challenging. Even though epidemiology may be of some help in orientating the clinician and even though some lesions may confidently be diagnosed on clinical grounds alone, the definitive diagnosis usually requires histopathologic evaluation. Oral pigmentation can be physiological or pathological, and exogenous or endogenous. Color, location, distribution, and duration as well as drugs use, family history, and change in pattern are important for the differential diagnosis. Dark or black pigmented lesions can be focal, multifocal or diffuse macules, including entities such as racial pigmentation, melanotic macule, melanocytic nevus, blue nevus, smoker's melanosis, oral melanoacanthoma, pigmentation by foreign bodies or induced by drugs, Peutz-Jeghers syndrome, Addison's disease and oral melanoma. The aim of this review is to present the main oral black lesions contributing to better approach of the patients.

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Figures

Figure 1
Figure 1
Labial melanotic macule. B). Increased numbers of me-lanocytes along the junctional zone (H&E, x 200). C) Intraoral me-lanocytic nevus located on the left buccal mucosa. D) Nevus cells located within the connective tissue (H&E, x 200). E) Blue nevus located on the right posterior hard palate. F) Blue nevus showing proliferation of dendritic melanocytes, elongated and spindle-shaped in connective tissue deep (H&E, x 100).
Figure 2
Figure 2
A) Melanoacanthoma on the right buccal mucosa. B) Me-lanoacanthoma showing proliferation of benign dendritic melanocytes scattered throughout the epithelium, acanthosis and spongiosis (H&E, x 100). C) Clinical aspect of amalgam tattoo on the gingival border bilaterally. D) Radiographic evaluation of amalgam tattoo. E) Oral melanoma located in gingival region. F) Histopathology of oral melanoma with atypical melanocytes, nuclear pleomorphism and hyperchromatism (H&E, x 100).
Figure 3
Figure 3
Peutz-Jeghers syndrome: black spots localized in the perioral area.
See this image and copyright information in PMC

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