Blue-Purple

Question 1

Varicosities / Venous Lake (Phlebectasis)

Answer 1

-Solitary, soft, compressible darker blue to violet papule
-Typically range from 0.2 to 1.0 mm in diameter
-Sun-exposed areas of the lip are commonly, leading to dilated blood vessel
-Diascopy positive and will blanch when pressed or depressed
-Treatment is cosmetic, but must diagnose properly to not confuse with nodular melanoma
-Laser ablation is a predictable fix and reoccurrence is rare and
based on exposure

Question 2

Amalgam or Graphite Tattoo

Answer 2

Grey or blue colored macule found on gingiva, palate or alveolar ridge
area
Due to entrapment of foreign body or debris
◦ Clinical restorative history will help with diagnosis
◦ Review previous radiographs or restorative work completed
◦ Radiopaque area or foreign body may appear on radiograph
Tx: None, continue to monitor size and shape or macule

Question 3

Melanocytic Nevus

Answer 3

Benign proliferation of nevus cell
Common on skin, Uncommon in mouth, but will likely occur on
palate
◦ Palate, buccal mucosa, gingiva, lip
Blue nevus and intramucosal nevus are most common type
85% are pigmented AND 70% are elevated
◦ No elevation in macule
Tx: Excisional biopsy to R/O malignancy, Malignancy is rare
Diff Dx: Melanotic macule, amalgam or graphite tattoo