Dental notes#"Pigmented Lesions of the Oral Cavity: Types, Diagnosis, and Clinical Significance скачать в хорошем качестве

Dental notes#"Pigmented Lesions of the Oral Cavity: Types, Diagnosis, and Clinical Significance

A pigmented lesion in the oral cavity refers to any area of increased pigmentation or discoloration within the mouth. These lesions can range in appearance, size, and location, and can be benign or malignant. Pigmented lesions in the oral cavity are often clinically significant, as they may indicate conditions that require further evaluation. Common Types of Pigmented Lesions in the Oral Cavity: 1. Oral Melanotic Macule (Focal Melanosis) Appearance: A flat, well-defined, brown to black spot or patch. The color can vary from light brown to dark black. Location: Commonly found on the lips, gingiva (gums), or hard palate. Causes: Benign accumulation of melanin (pigment) in the mucosal epithelium. It can also appear due to chronic irritation, such as smoking or trauma. 2. Oral Melanoma (Malignant Melanoma) Appearance: Irregularly shaped, darkly pigmented lesion, often with an uneven color pattern (black, blue, brown). It may have an ulcerated or raised surface. Location: Typically found on the palate or gingiva, though it can appear anywhere in the oral cavity. Causes: Malignant growth of melanocytes, which are the cells responsible for pigment production. Risk: Rare but aggressive, with the potential for rapid spread to other parts of the body. Early detection is critical for prognosis. 3. Nevi (Moles) Appearance: Small, well-defined pigmented lesions, usually brown or black in color. Can be flat or raised. Location: Typically on the palate, gingiva, or buccal mucosa (inner cheek lining). Causes: Benign proliferations of melanocytes. Oral nevi are rare but may appear due to genetic factors or childhood trauma. 4. Amalgam Tattoos Appearance: Blue, gray, or black discoloration caused by amalgam (dental filling material) particles being embedded in the oral mucosa. Location: Commonly found on the gingiva, buccal mucosa, or palate. Causes: Accidental implantation of amalgam during dental procedures or trauma. 5. Post-Inflammatory Hyperpigmentation Appearance: Darkened areas of the mucosa that develop following inflammation or injury. The pigmentation can range from light brown to dark black. Location: Can occur anywhere in the mouth, typically where previous trauma, ulcers, or infections were present. Causes: Melanin production increases in response to the healing process after injury or inflammation. 6. Peutz-Jeghers Syndrome Appearance: Small, flat, dark brown or blue macules. Location: Typically found on the lips and oral mucosa (buccal mucosa, gingiva, or palate). Causes: A genetic condition that leads to the development of pigmented lesions on the skin and mucous membranes, as well as gastrointestinal polyps. It is associated with an increased risk of certain cancers. 7. Drug-Induced Pigmentation Appearance: Brown or black pigmentation that develops due to certain medications. Location: Commonly on the gingiva or palate. Causes: Drugs like antimalarial medications (chloroquine), certain antibiotics, and chemotherapeutic agents may cause pigmentation in the oral cavity as a side effect. 8. Submucosal Hemorrhage (Petechiae or Ecchymosis) Appearance: Red, purple, or black lesions that result from bleeding beneath the mucosa. Location: Can occur anywhere in the mouth, including the gums, palate, or tongue. Causes: Trauma, blood disorders, or medications that affect blood clotting (such as anticoagulants). Evaluation of Pigmented Lesions in the Oral Cavity A biopsy is often necessary to determine the nature of a pigmented lesion, particularly if there are any concerns about malignancy (e.g., oral melanoma). The following features should be evaluated: Color: A uniform color is more likely to be benign, while uneven color distribution may suggest malignancy. Shape and Borders: Irregular borders and asymmetry are concerning signs of malignancy. Size: Lesions that are growing in size or have changed in appearance should be evaluated. Symptomatology: Pain, bleeding, or ulceration may indicate a more serious condition. Management Benign Lesions: Often require no treatment unless they cause cosmetic or functional concerns. Malignant Lesions: Require prompt intervention, which may involve surgical excision, radiation, or chemotherapy, depending on the stage and location of the cancer. It's important to consult a healthcare provider for a definitive diagnosis and appropriate management of any pigmented lesion in the oral cavity.