Oral melanotic macule in Adult
Although benign, biopsy may be needed to rule out a diagnosis of melanoma. Oral melanotic macule is common in patients with darker skin phototypes and is seen more frequently in women than men. Although these macules may appear at any age, the average age at time of presentation to the physician is 40 years. In patients with darker skin phototypes, onset typically occurs in adolescence.
D10.30 – Benign neoplasm of unspecified part of mouth
403449001 – Melanotic macule of oral mucosa (reactive type)
- Amalgam tattoo (exogenous pigmentation) – This is the most common intraoral pigmented lesion. Usually, the amalgam tattoo is not elevated and particles of dental amalgam (silver filling material) can often be detected on periapical radiographs of the lesional site.
- Melanoacanthoma – This uncommon condition occurs most frequently in young adult women of African descent, typically on the buccal mucosa. The lesion is generally much larger (1 cm or greater) than a melanocytic nevus, and it often follows a characteristic pattern of spontaneous involution over a period of days to weeks.
- Melanoma – Both primary and metastatic melanoma are rarely seen intraorally, and in their earliest phases could be mistaken for melanocytic nevus.
- Nevus or blue nevus
- Varix (venous lake) is a common lesion on the lower vermilion, but this tends to be a papule or bleb that blanches if pressure is applied to it. It also tends to occur in older adults.
- Smoker's melanosis tends to be located on the anterior mandibular buccal-attached gingiva in a bilaterally symmetric distribution.
- Peutz-Jeghers syndrome
- Carney complex
- LEOPARD syndrome
- Drug-induced pigmentation (eg, antimalarials, tetracyclines, some chemotherapeutic agents)
- Heavy metal poisoning (see arsenic poisoning, lead poisoning, mercury poisoning, thallium poisoning)
- Addison disease
- Kaposi sarcoma
- Albright syndrome
- Laugier-Hunziker syndrome