Amalgam tattoo - Oral Mucosal Lesion
Alerts and Notices
Synopsis
Amalgam tattoos are a common macular pigmentation caused by pieces of amalgam (silver filling material) accidentally implanted into the mucosa. It is asymptomatic.
Codes
ICD10CM:
K13.79 – Other lesions of oral mucosa
SNOMEDCT:
109789004 – Amalgam tattoo
K13.79 – Other lesions of oral mucosa
SNOMEDCT:
109789004 – Amalgam tattoo
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Physiologic (racial) pigmentation – Usually a widespread, diffuse, symmetric eruption.
- Oral mucosal melanotic macules – Typically brown-black in color.
- Oral melanoacanthoma – Rapid increase in size and then resolution.
- Melanocytic nevus
- Smoker's melanosis
- Melanoma – Larger, asymmetric, nonuniform pigmentation.
- Carbon pigmentation – Exposure to lead in pencils.
- Drug-induced pigmentation – Minocycline, anti-malarials, birth control pills, and clofazimine are common culprits.
- Systemic metallic intoxication – Exposure to lead, mercury, bismuth, etc.
- Melanotic macules – Typically associated with systemic conditions (Peutz-Jeghers syndrome, Albright syndrome, and Addison's disease).
- Varicosities and other small vascular lesions
Best Tests
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Management Pearls
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Therapy
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References
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Last Updated:09/26/2013
Amalgam tattoo - Oral Mucosal Lesion