Laugier-Hunziker syndrome: a report of three cases and literature review

Abstract

Laugier-Hunziker syndrome (LHS) is an acquired pigmentary condition affecting lips, oral mucosa and acral area, frequently associated with longitudinal melanonychia. There is neither malignant predisposition nor underlying systemic abnormality associated with LHS. Herein, we present three uncommon cases of LHS with possibly new feature of nail pigmentation, which were diagnosed during the past 2 years. We also review the clinical and histological findings, differential diagnosis, and treatment of the syndrome in published literature.

Figure 1

Clinical photographs in case 1. Extensive diffuse brownish to black pigmentation on vermilion and mucosa of the lower lip (a); multiple, discrete, well-defined, lenticular or irregularly shaped, faint brown to dark macules distributed over the buccal mucosa (b), the gingiva and the dorsum of tongue (c). A double longitudinal pigmented band was present on the fingernail of the right thumb (d) and a faint brown macule appeared on the fingertip of the right thumb (e). Two irregular brown spots with flat and smooth surface were noted on the left first toenail (arrows). A transverse black streak of the same toenail, associated with groove, was not pigmentary change of LHS due to the atrophy of nail plate (f).

Figure 2

Histopathological features in case 1. An accumulation of melanin is confined to the basal layer, especially affecting the tips of epithelial rete pegs (arrows). (a and b) Hematoxylin and eosin staining, a, ×100; b, ×400.

Figure 3

Clinical photographs in case 2. Extensively diffuse pigmentation distributed over the upper and lower gums (a). A single longitudinal pigmented band or multiple longitudinal pigmented bands were present on parts of the fingernails (b). There was irregular or stippled pigmentation on the nail of index finger (c). An ill-defined 3 mm×2 mm brown macule was noted in the inferior temporal quadrant of the left conjunctiva (d).

Figure 4

Clinical photographs in case 3. Multiple, round- to ovoid-shaped, blackish macules were present on his lips (a). A brownish macule was observed on the interdigital area of the left little toe (b). Some irregularly shaped or stippled pigmentation was noted on parts of his fingernails (c).