oral pigmentation Flashcards
in which pigmented abnormalities would you expect to see one singular pigmented area?
- amalgam tattoo
- haemangioma
- melanotic macule
- malignant melanoma
- kaposi’s sarcoma
in which pigmented abnormalities would you expect to see multiple pigmented areas?
- physiological pigmentation
- smoker-associate melanosis
- addison’s disease
- betal nut chewing
- black hairy tongue
what should you always consider when there is pigmentation in the mouth??
always exclude malignant melanoma first
identify this pigmented abnormality
features?
management?
amalgam tattoo
- implantation of amalgam into tissues
- single black area
- completely flat
- can occur during
- extractions
- when removing amalgam with fast handpiece
- radiograph to exclude malignant melanoma
- will show amalgam in soft tissues
- treatment
- no active treatment
identify this pigmented abnormality
features?
management?
haemangioma
- congenital vasular abnormality
- single raised blue lesion
- feels fluid filled - with blood
- treatment
- no active treatment
- smaller can cryosurgery
- larger can be embolised
- injected into to make smaller
identify this pigmented abnormality
features?
management?
melanotic macule
- focal pigmentation
- flat brown distinct lesions
- treatment
- none
- take pictures and compare with 8 weeks later
identify this pigmented abnormality
features?
treatment?
melanotic macule
- focal pigmentation
- flat brown distinct lesions
- treatment
- none
- take pictures and compare with 8 weeks later
- none
identify this pigmented abnormality
features?
treatment?
malignant melanoma in the mouth
- different shades of pigmentation within it
- grows in size
- treatment
- radical excision
- 5 year survival 20%
- radical excision
identify this pigmented abnormality
features?
treatment?
malignant melanoma in skin
- variable presentation
- dark rapidly growing nodule
- slow growing pigmented macule (flat lesion) that gradually darkens
- treatment
- suspected lesions should be excised with 2mm margin
- further management determined by breslow thickness
what should we check to exclude malignant melanoma?
- check ABCD
- asymmetry
- border
- colour variation
- diameter >6mm
identify this pigmented abnormality
features?
treatment?
kaposi’s sarcoma
- proliferation of endothelial cells
- human herpes virus 8
- in people who are immunosupressed
- single flat lesion
- palate and gingivae
- treatment
- excision
identify this pigmented abnormality
features?
treatment?
kaposi’s sarcoma
- proliferation of endothelial cells
- human herpes virus 8
- in people who are immunosupressed
- single flat lesion
- palate and gingivae
- treatment
- excision
identify this pigmented abnormality
features?
treatment?
physiological pigmentation
- widespread variation
- no active treatment
identify this pigmented abnormality
features?
treatment?
smoker-associated pigmentation
- stimulation of melanocytes - due to heat and irritation of tobacco smoke
- melanin deposition
- diffuse pigmentation in palate and buccal mucosa
- management
- discontinue smoking
identify this pigmented abnormality
features?
treatment?
addisons disease
- primary adenocortical insufficiency
- autoimmune disease
- reduced cortisol, increased ACTH
- diffuse pigmentation
- pigmentation of skin also
- management
- steroid replacement
identify this pigmented abnormality
features?
treatment?
betal nut chewing
- pigment in areca nut
- black pigmentation of teeth and soft tissues
- risk of oral cancer
- management
- stop habit
identify this pigmented abnormality
features?
treatment?
black hairy tongue
- elongation of the filliform papillae
- treatment
- removal with tongue scraper
- patient brushes tongue to prevent build up
