Download - Oral Pigmentations
Oral Medicine
Topic #1: Pigmentations of Oral and Peri-oral Tissues
Done by:Abeer KhasawnehExtrinsic stain or die
Melanocytes
Nevus cells
Freckles
Myxoma syndrome (Carneys syndrome)
Lentigo
Melanotic macule
Melanotic maculeMelanotic macule
Increased melanin pigmentation within the basal cell layer with melanin incontinence.
Melanotic maculeMelanoacanthoma
Dendritic-shaped, pigmented melanocytes (arrows) are noted throughout the full thickness of a spongiotic and acanthotic epithelium.Congenital Nevi (moles)
Classification
Intramucosal nevusIntramucosal nevus
The nevus cells are located withinthe submucosal tissue, with no evidence of any junctional component. The superficial melanocytes are heavily pigmented. Melanin is less evident in the remaining cells.Intramucosal nevus
Compound nevus
Nevus cells are located at the junction of the epithelium and connective tissue and within the submucosal tissue.The cells are variably pigmented.Compound nevus
Junctional nevus
Blue nevus
Skin Melanoma
Skin Melanoma
Malignant Oral Melanoma
Malignant Oral MelanomaMacular but diffuse involvement of the maxillary gingiva.
One portion of the tumor is heavily pigmented (arrow), whereas the opposite side is relatively amelanotic.Malignant Oral Melanoma
Melanoma of the upper lip presenting as an ulcerated mass with multifocal areas of pigmentation.Malignant Oral MelanomaOral Melanoma
Nests of melanoma cells demonstrating nuclear pleomorphism and hyperchromatism and deposits of melanin pigment.
Heavily pigmented melanoma exhibiting primarily a radial growth phase with pagetoid spread of tumor cells (hematoxylineosin stain).Oral MelanomaOral Melanoma
Neuroectodermal tumor of infancy
Note the patchy distribution of the pigment.Physiologic pigmentation
Physiologic pigmentation
Physiologic pigmentationMelanin in a macrophageSmoking-associated melanosis
Lichen planusassociated pigment. Classic-appearing Wickhams striae and surrounding pigmentation (arrows) are seen in this Caucasian patient with biopsy-proven lichen planus.Post-inflammatory pigmentationsPost-inflammatory pigmentations
Melasma
Pigmentation (arrows) developed on the foreheadof this female during the second trimester of pregnancy.
MelasmaEndocrinopathic pigmentations
Addisons disease
Addisons diseaseAdrenocortical hyperfunctionCushings disease (syndrome)
Peutz-Jeghers syndrome
Multiple small macules on the fingertips (arrows).Peutz-Jeghers syndromeSkin pigmentationsOral / perioral pigmentationsIntestinal polypsCutaneous menlanotic spots (Caf-au-Lait)
HIV-Associated melanosis
Laugier-Hunziker syndrome
Segmental vitiligo
Vitiligo
Ecchymosis-Haematoma
Diascopy
Haemochromatosis
Amalgam Tattoo
Amalgam tattoo of the maxillary alveolar mucosa. The pigment was associated with a retrograde amalgam restoration.Amalgam TattooAmalgam Tattoo
Amalgam particles are dispersed throughout the submucosal tissue.Amalgam TattooHeavy metal pigmentations
Discoloration of the alveolar mucosa associated with extensive crown and bridge restoration.Heavy metal pigmentations
Gingival staining due to poor quality metals.Heavy metal pigmentations
Generalized pigmentation due to lead poisoning. The gingival margin is pigmented.Drug-induced pigmentations
QuinidineChlorpromazine
Drug-induced pigmentations
Chlorquine
HydroxyclorquineHairy tongue
The end