Pigmented lesions

Question 1

Black Hairy tongue - cause

Answer 1

overgrowth of filiform papillae accompanied by bacterial pigmentation from commensal flora

Question 2

black hairy tongue appearance and clinical features

Answer 2

often brown in colour
harmless
may cause anxiety for patient

Question 3

black hairy tongue management

Answer 3

gently rubbing dorsum of tongue with toothbrush or sucking on a peach stone

Question 4

amalgam tattoo cause and features

Answer 4

presents as grey-black discolouration of the mucosa
caused by entry of dental amalgam into mucosa at time of restoration placement or tooth extraction

Question 5

Why might excision biopsy be indicated for an amalgam tattoo?

Answer 5

to exclude melanotic lesions

Question 6

malignant melanoma features

Answer 6

diffuse lesion
presenting mostly on palate or gingiva
may evolve into a nodular ulcerated tumour - poor prognosis
early diagnosis can lead to excision and cure

Question 7

diffuse oral melanosis cause

Answer 7

caused by an increased release of melanin in response to chronic irritation
e.g. smoking or chronic inflammatory disease involving the oral mucosa