Pigmentary Changes involving the Oral Cavity Flashcards
What is this an example of?
Amalgam tattoo
Describe the shape of an oral melanoma lesion
Irregular, poorly defined borders & thickening in nodular phase
What is this an example of?
Amalgam tattoo
Where are amalgam tattoos commonly found?
Mandibular gingivae and alveloar mucousa
What is this an example of?
Black hairy tongue with geographic tongue
Besides OHI what should be implemented in a patients brushing routine with black hairy tongue?
Tongue brushing
(but avoid excessive brushing which may worsen prominent filiform)
What is an oral melanoma?
Malignant tumour of Melanocytes
Where are common sites for oral melanoma lesions?
Palate (most common)
Lips
Gingivae
When a graphite tattoo is expected what should be done?
Biopsy mandatory to rule out malignancy
What is this an example of?
Ethnobotanical tattooing
Done by African tribes on women for rites of passage
Oral melanotic macules found on the lip may arise due to what?
Lesions on the lip may represent reaction to sun damage
What is this an example of?
Varices
At a cellular level what causes oral melanotic macules?
Focal increase in melanin production
What can be prescribed to a patient to help manage black hairy tongue?
Oxidising mouthwash (peroxyl)
What is this an example of?
Black hairy tongue
What is this an example of?
Black hairy tongue
What is this an example of?
Amalgam tattoo
What is the prognosis of oral melanoma?
Poor prognosis of 5-20% 5 year survival
Often metastasises as it has a rich blood and lymph node supply
Where are graphite tattoos commonly seen?
Often seen on anterior palate of younger children
(from chewing of graphite pencils)
What can spontaneous ecchymosis (brusing) suggest?
May indicate platelet/coagulation disorder or leukaemia
What is the clinical name of an amalgam tattoo?
Focal Agyrosis
What is this an example of?
Oral melanotic macules
What are some predisposing factors of black hairy tongue?
Antiseptic mouthwash use
Broad spectrum antibiotics
Heavy smokers
Poor OH
What is this an example of?
Graphite tattoo
What is this an example of?
Metal salt deposition
From bismuth, lead, mercury salts
What groups of individuals have predisposing factors for oral melanoma?
Females
African & Japanese
People with increased UV radiation exposure
What is this an example of?
Ecchymosis (bruising)
When can amalgam tattoos arise?
Following;
XLA of an amalgam-filled tooth
Removal of amalgam restoration
What causes oral melanotic macules?
Focal increase in melanin production
What happens in the oral cavity during black hairy tongue?
Elongation of filliform papillae
Where pigment producing bacteria can grow
This causes extrinsic staining
