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Pigmentations (Ch 14) - Coggle Diagram

- - - - Sclera, nailbeds and other tissues may become pigmented; orally appears as generalized darker pigmented areas in the alveolar, palatal, and vestibule areas
    - - Prescribed for skin conditions over months or years may affect teeth and oral mucosa; patients may request bleaching and cosmetic procedures
    - - Not applicable
    - - No treatment is needed, but discontinuing the medication leads to a good prognosis
    - - Caused by ingestion of minocycline; a semi synthetic tetracycline; a broad-spectrum antibiotic used in treatment of acne and other inflammatory and immune mediated diseases
  - - - Lips may be affected, perioral tissue at the wet line of the lips; orally light pigmentation occurs with labial gingiva since this is a target region; Soft palate may exhibit light brown pigmentation that is diffuse; tongue may be pigmented with soft brown elongation of filiform papillae; both chemicals and heat or a factor in the accentuated papillae
    - - Any tobacco products used increases the risk of oral cancer; careful follow up with the patient is crucial; patient should be educated about oral cancer, taught to do an oral cancer self-screening examination, and smoking cessation should be recommended
    - - Not contagious
    - - Smoking cessation is the most appropriate treatment; discontinuation usually results and resolution of pigmentation; prognosis is excellent when patient stops using tobacco
    - - Tobacco products that stimulate the production of melanocytes within the tissue
- - - - The nevus may occur on any cutaneous surface; intra-mucosal nevus is rare; nevi are usually found in the political region; may be seen clinically in shades of gray, brown, and blue; usually well circumscribed and slightly raised; all intraoral nevi should be removed surgically; Should be recorded and 3D documentation
    - - Intraoral nevus must be differentiated from a melanoma through removal and biopsy; melanoma is highly malignant and must be treated rapidly and totally removed
    - - Not applicable
    - - Biopsy is performed on the intraoral nevus, which is totally removed during surgery
    - - Commonly referred to as a mole; also known as pigmented nevus, melanocytic nevus, and nevomelanocytic nevus; pigmented intraoral lesion is sometimes referred to as mucosal nevomelanocytic nevus or melanocytic nevi; genetic predisposition blue nevus is second most common type of melanocytic nevus; usually occurs on the pallet, followed by buckle mucosa; may become malignant
  - - - Usually multiple if found on buccal mucosa; most often seen on the lip followed by the palate and gingival and buccal mucosa; when occurring on the lip it appears as a freckle
    - - If changes such as increased growth or shape occur there could be a suspicion of lentigo maligna; often seen on faces of older individuals; possibility of melanoma is always a concern with any lesion change, whether macule is a freckle, melanotic macule, or lentigo maligna
    - - Not applicable
    - - It is suggested that all pigmented lesions, which have an unknown duration, recent onset, or have changed in anyway, be submitted for biopsy
    - - Occurs on the lip or the intro oral tissues; the most common oral lesions of melanocytic origin; sun exposure is not an etiology; Synonyms for melanotic macules are Hutchenson freckle and melanotic freckle
- - - - May extend into the lip; may range from brown to black to dark blue; may see on tongue; Physiologic pigmented lesions do not blanch because they are due to melanin production; not caused by excess blood in focal areas such as the hematoma, ecchymosis, or petechiae
    - - None except for cosmetic factors which may gain complaint
    - - Not applicable
    - - Prognosis is excellent; no treatment is required once a definitive diagnosis is confirmed
    - - Physiologic; usually found in gingiva but can occur throughout mouth; increased pigmentation may occur in pregnancy or in post menopausal women on HRT
- - - - Usually found adjacent to placed amalgam, in previous restorative sites, or in a previous extraction site; diagnosed through clinical and radiographic appearance; usually localized, involving the gingiva and rarely the floor of the mouth; gray to blue/black; distinguishing by opaque fragments of metal apparent in radiographs
    - - The cause of any pigmented area should be determined to rule out serious pathology such as melanoma
    - - Not applicable
    - - No treatment is indicated; prognosis is excellent
    - - Amalgam particles become embedded within the tissue; also known as focal argyrosis
- - - - Nail involvement occurs in about 50% of patients; macules appear on toes, fingers, lips, and other cutaneous areas; dark brown pigmentation is most often seen on buccal mucosa and lips
    - - Pigmentation may occur suddenly, symptoms may be confused with many other disease states
    - - Not applicable
    - - Syndrome is benign, but it is important to include in differential diagnosis of pigmentary disorders of the oral mucosa since it may be confused with more serious diseases such as Addison disease, melanoma, and Peutz-Jagher's disease
    - - Unknown etiology; no history of a genetic or congenital history; has a distinctive characteristic of pigmentation that mimics several pigmented lesions; LHS is an acquired, benign, idiopathic, macular hyper pigmentation of the lips and oral mucosa, as well as other cutaneous areas, often includes nail pigmentation
- - - - Most common sites are the hard palate and maxillary gingiva; usually a brown, red, black, and even black-bluish color; maybe slightly raised, with irregular borders; may have a rapid growth pattern, with a deep invasive nature; may appear exophytic or ulcerative, colors may be mixed, depending upon the stage; asymmetry and irregular borders are key signs related to melanomas
    - - Deadly, should be recognized and removed and its earliest stage; may be confused with the blue nevus or amalgam tattoo; pain is not a feature
    - - Not applicable
    - - Oral melanoma is very aggressive; much poor prognosis then melanomas found elsewhere on body; excision is the course of action; chemotherapy and radiation maybe used as well; associated with a poor prognosis because a tendency to metastasized to other organs and tissues
    - - Rare, etiology is very different for oral melanoma's and not clearly understood; tobacco use, chronic irritation, formaldehyde exposure, familial history, and psychogenic defects are implicated; a pigmented area usually in the palate or maxillary gingiva precedes this lesion