Oral pigmentation

Abstract

Oral pigmentation may be physiological or pathological in nature. It may represent a localized anomaly of limited significance or the presentation of potentially life-threatening multisystem disease. Evaluation of a patient with oral pigmentation requires a systematic approach with resource to appropriate investigations in certain circumstances. A full history of evolution of the pigmentary changes, as well as inquiring into family history, drug ingestion and systemic symptoms of concurrent disease are clearly important in the assessment. The duration, pattern, hue and distribution of colour changes can provide useful diagnostic clues. Special attention is given to newly appearing lesions, or those that have changed significantly in appearance, and biopsy may be needed to validate the clinical impression. This review should enable the reader to increase their familiarity with the assessment of oral pigmentation, the common causes of oral pigmentary change and the rarer disorders of pigmentation seen in this area. The systemic diseases that may give rise to oral pigmentation are detailed and the early signs of oral melanoma are highlighted, as well as the drugs which may cause pigmentary changes in this area and the different pattern of pigmentation they may induce.

Drugs Causing Orofacial Pigmentation: An Overview of Literature

“…The physiologic color of the oral mucosa thus ranges from white to red-purple in light-skinned people, whereas an evenly black to brown color of gingival and buccal mucosa and the lips are characteristic of darkskinned people. 1,2,3 Oral mucosal discoloration, which ranges from brown to black, may be due to superficial (exogenous pigmentation) or deep (endogenous pigmentation). Exogenous pigmentation is rarely of consequence and is usually caused by colored foods, drinks or drugs.…”

Oral Mukozanın Benign Pigmente Lezyonları

“…Hastalarda siroz, diyabet ve kalp yetmezliği görülür. Yaklaşık %25 hastada hemosiderin birikimine bağlı sert damak ve gingivada kahverengi veya gri renkte pigmentasyon oluşmaktadır 8 . Beta-talasemi hastalarında hemoglobin parçalanması sonucu metalik birikim oral mukozada kahverenkli pigmentasyona neden olmaktadır 7 .…”

“…Bu klinik görüntü fizyolojik pigmentasyona benzer. Ancak hastalarda sistemik buguların olması (halsizlik, bulantı, kusma, karın ağrısı, konstipasyon ya da diare, kilo kaybı, hipotansiyon) ve erişkin yaşta başlayıp ilerlemesi ayırt edici bulgulardır 2,8 .…”

“…Melanotik lezyonların tedavisi gerekli değildir, melanom riski yoktur. Ancak hastalar internal maliniteler açısından takip edilmelidir 7,8,10 . Peutz-Jeghers sendromu, ayrıca ilgili bölümde (Bkz.…”

Efeitos adversos de medicamentos tópicos e sistêmicos na mucosa bucal

“…A pigmentação dos tecidos moles, na cavidade bucal pode ser tanto de natureza fisiológica como patológica 23 (doença de Addison, síndrome de Peutz-Jegher, doença de Albright, neurofibromatose, entre outras), de origem exógena ou endógena. A história da alteração de pigmentação, assim como a investigação quanto ao histórico familiar, uso de medicamentos, duração, coloração e distribuição das lesões são importantes para o diagnóstico diferencial.…”