The differential diagnoses to consider with malignant lentigo are the following: solar lentigo, seborrheic keratosis, keratotic lichen planus, actinic keratosis, and melanocytic nevus.
Its treatment is based on surgical excision with histological examination. As a second line of treatment, topical imiquimod chemotherapy and radiotherapy can be used [ 10 ]. Lentigo, still called unique melanotic macule, is common in adults and is of a benign nature. It manifests in the form of a brown or blackish macule that can measure 0. It can affect the skin and mucous membranes. The usual location in the oral cavity is the lower lip.
Lead poisoning with pigmentation of the oral mucosa. Review of the literature and report of a case.
In addition, in patients with dark skin, this lesion can be found on the tongue or the palate [ 11 — 13 ]. When these macules are multiple, we talk about lentiginosis. The histological examination finds epithelial hyperplasia, acanthosis, melanic pigmentation of the basal layers of the epithelium hypermelanocytosisand many melanophages in the underlying layers.
There is no regrouping in thecas. Nevocellular nevus is infrequent in the oral mucosa and more often affect subjects aged 30—40 years. It is frequently located on the palate, to the inside of the cheeks and sometimes gum and the labial mucosa in the form of a macule with a size 0.
It can also manifest in the form of a nodule. Clinical distinction is difficult between a nevocellular nevus and melanoma, thus the need for histological analysis [ 15 ].
Histological analysis found a proliferation of nevus cells, regular, rounded, grouped in thecas or layers within the basal membrane and the lamina propria.
Pigmentation of oral
Blue nevus is rare in the oral mucosa, and is most often located on the palate. It is most often found in children and young adults, and in women. It has bluish gray color, and can be macular or nodular. Fusiform cells located exclusively in the lamina propria can be found on the histological sections. The deep location of these cells explains the bluish coloration of the nevus. Blue nevus generally does not degenerate, but its resemblance to melanoma is an indication for surgical excision.
Melanoacanthoma is exceptionally rare in the oral mucosa and is more often found on the palate and inner cheeks. It affects young adults and most frequently women with black skin. Local trauma or a history of chronic irritation are triggering factors. It can measure up to several centimeters in diameter. The pigmentation of exogenous origin can be either accidental or voluntary.
Pigmentation of accidental causes may be due to tar, pigmentation due to the metals present in the fillings or crowns.
Sometimes a mucosal break with intramucosal deposit of dental material may be observed. Pigmentation of voluntary origin may be because of ethnic pigmentations in African tribes or because of tattoos with the presence of pigmented scar on cheeks or the buccal gingiva [ 16 ]. Pigmentation of vascular origin is dark red or purplish, close to black. These lesions are represented by bruises, angiomas plans, and Kaposi's disease. The vascular nature of the lesion manifests as diurnal changes in angioma volumes, the position of the head, the heat and by their blanching to the pressure.
In Kaposi's disease, the lesion is macular or nodular, with dark purplish coloring, and diffuse location, with a possible extension to the whole body. Essential melanosis or Laugier—Hunziker syndrome belongs to the group of single pigmented macules occurring in adults. Although rare, it is necessary to know how to clinically diagnose when encountering a single, flat pigmented lesion of the oral cavity, particularly in women of Caucasian origin.
Pigmentation palatine associée à un traitement par imatinib
Even if clinical suspicion is strong, the only way for a final diagnosis of a pigmented oral lesion remains the histopathological examination. Therefore, it is necessary to reinforce the importance of a comprehensive intraoral examination during any consultation with the dental surgeon, complemented by full dermatological examination if there is a mucosal lesion as required.
Early detection of melanoma and prompt treatment allows for a decrease the morbidity and mortality of this pathology. Data correspond to usage on the plateform after The current usage metrics is available hours after online publication and is updated daily on week days.
Open Access. Issue Med Buccale Chir Buccale. Lésions pigmentées de la cavité buccale.
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