Pigmented lesions Flashcards
Examples of exogenous oral pigementation
-superficial staining of mucosa
-black hairy tongue
- foreign bodies e.g., amalgam tattoo
- heavy metal poisoning
- drugs e.g., NSAIDs, antimalarials, chlorohexidine
what is black hairy tongue
hyperplasia of papillae in the dorsum of the tongue and overgrowth of pigment producing bacteria
much more common in smokers
black hairy tongue treatment
no immediate tx
tongue scraping and good OH should improve appearance
how does an amalgam tattoo present
symptomless blue/black lesion
may be seen on radiograph
amalgam tattoo histology
pigment present as widely dispersed, fine brown/black granules or solid fragments
associated with collagen and elastic fibres and basement membranes
amalgam tattoo treatment
none required
Examples of endogenous oral pigmentation
melatonic macule
pigmented nave
Peutz-Jeghers syndrome
Smokers melanosis
HIV infection
manifestation of Addison’s
mucosal melanoma
melanotic neuroectodermal tumour of infancy
description of melatonic macule
well defined small flat brown/black lesion
due to increased activity of melanocytes
buccal mucosa, palate and gingiva - most common sites
is melanotic macule begin or malignant
benign
treatment of melanotic macule
frequently excised to confirm diagnosis and exclude melanoma
histopathology of melanotic macule
increased melanin pigment in basal keratinocytes - not increased number of melanocytes
What is mucosal melanoma
malignant neoplasm of mucosal melanocytes
mucosal melanoma most common intraoral sites
hard palate and maxillary gingiva
mucosal melanoma features
- dark brown or black, if non-pigmented - red
- typically asymptomatic at first
- may remain unoticeduntil pain, ulceration, bleeding or neck mass
- regional lymph node and blood-borne metastases are common
- typically very advanced at presentation
- very invasive
- prognosis poor
- aetiology unknown
Histopathology of mucosa melanoma
melanomas are highly pleomorphic neoplasms, cells appear epithelioid or spindle shaped
