WELCOME PIGMENTED LESIONS OF ORAL MUCOSA
Oral and Perioral pigmentation may be physiologic (or) pathologic in origin.
Assume variety of discolorations, including brown,blue, grey & black.
These color changes often occur due to deposition,production (or) increased accumulation of various endogenous (or) exogenous pigmented substances.
sygdom.info CLASSIFICATION ENDOGENOUS PIGMENTATION FOCAL MELANOCYTIC PIGMENTATION . Freckle / Ephelis . Oral / labial melanotic macule . Oral melanoacanthoma . Melanocytic nevus . Malignant melanoma MULTIFOCAL / DIFFUSE PIGMENTATION . Physiologic pigmentation . Drug induced melanosis . Smoker melanosis . Post inflammatory hyper pigmentation . Melasma (chlosma)
sygdom.info MELANOSIS ASSOCIATED WITH SYSTEMIC (OR)GENETIC DISEASE . Hypo adrenocorticism (addison’s disease) . cushing’s syndrome . Hyperthyrodism (graves disease) . Primary biliary cirrhosis . Vitamin b deficiency . Peutz jeghers syndrome . Café au lait pigmentation . HIV / AIDS associated melanosis
sygdom.info IDIOPATHIC PIGMENTATION Laugier – hunziker pigmentation DEPIGMENTATION Vitiligo HAEMOGLOBIN & IRON ASSOCIATED PIGMENTATION a. Ecchymosis b. Purpura / Petechiae c. Hemochromatosis
sygdom.info EXOGENOUS PIGMENTATION
DRUG INDUCED AMALGUM PIGMENTATION TATTOOS
HEAVY METAL GRAPHITE PIGMENTATION TATTOOS
MEDICINAL ORNAMENTAL METAL INDUCED TATTOOS PIGMENTATION Common causes of endogenous oral and perioral discoloration Examples of associated lesion, Etiology Source condition or disease Varix, hemangioma, lynphangioma, Developmental, hamartomatous , neoplastic, angiosarcoma, kaposi’s sarcoma, Vascular autoimmune hereditary hemorrhagic talangiectasia, CREST syndrome.
Extravasated hemorrhage hemosiderin Trauma, idiopathic, genetic, inflammatory, Hematoma, ecchymosis, purpura, autoimmune petechiae, vasculitas, hemochromatosis.
Melanotic macule, ephelis, actinic lentigo, melanocytic nevus, malignant Melanin Physiologic, developmental, idiopathic, melanoma, physiologic pigmentation, neoplastic, reactive drugs, hormones, genetic, chloroquine-induced pigment, lichen auto immune, infectious. planus pigmentosus, laugier-hunziker pigmentation, smokers melanosis, oral- sub mucous fibrosis, peutz-jeghers disease, adrenal insufficiency, cushing’s syndrome, HIV/AIDS.
Bilirubin Trauma, alcohol, infection, neoplasia, genetic, Jaundice. auto immune.
Focal melanocytic pigmentation Freckle / ephelis : The cutaneous freckle is a commonly occuring, asymptomatic , small ( – mm), well circumsribed , tan or brown colored macule that is often seen on sun exposed regions of facial & perioral skin. Polymorphisms in mc r gene is strongly associated with development of childhood freckles. Oral / labial melanotic macule Etiology is trauma More commopn in females usually in lower lip &gingiva. May develop at any age but generally tend to present in adulthood. Melanotic macules tend to be small (<