Brown lesion on the tongue of a child

Abstract

A healthy 4-year-old Japanese boy was referred for a blown lesion on the tongue present since birth and increased in size with his body growth.He was born at term and developing normally. His parents had no family history of melanoma, mucosal pigmentation, and polyposis. His skin phototype was estimated to be III. Intraoral examination showed a wellcircumscribed, flat, soft, smooth, 8 × 6 mm brown macule on the dorsal tongue (Figure 1). The lesion could not be scraped by gauze. Extraoral examination demonstrated no cervical lymphadenopathy. | WHAT IS YOUR D IAG NOS IS?Based on the patient's history, physical examination, and laboratory findings, which one of the following is the most suspicious diagnosis? 1. Addison disease (Primary adrenal insufficiency) 2. Black hairy tongue 3. Congenital lesion 4. Melanoma 5. Peutz-Jeghers syndrome This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.