Laugier-Hunziker Pigmentation or Syndrome
Etiology: Distinct characteristic of pigmentation that mimics several of the pigmented lesions. It is acquired, benign, idiopathic, macular hyperpigmentation of the lips and oral mucosa, as well as other cutaneous areas.
Epidemiology: Reported mostly in white populations, women are affected more frequently than men.
Pathogenesis: Thought to be linked to a functional alteration of the melanocytes that induce increased synthesis of melanosomes and their subsequent transport to the basal layer cells.
Extraoral characteristics: Nail involvement occurs in half of patients. Nail pigmentation may present with thick wide bands of hyperpigmentation and appear as hutchinson sign. Macule may range from 1 to 5 mm on toes, fingers, lips, and other cutaneous areas.
Perioral and intraoral characteristics: Dark brown pigmentation is most often seen on the buccal mucosa and lips. The hard and soft palate may also be involved and, less frequently, the gingiva, the floor of the mouth, and the tongue.
Distinguishing characteristics: Nail pigmentation is a characteristic, containing bands or streaks of pigmentation. Racial pigmentation occurring orally or in the nails is not usually seen in whites.
Significant microscopic features: Basilar melanosis with increased numbers of melanophages in the lamina propria is normally present.
Dental implications: May occur suddenly, and the patient may be apprehensive about the cause.
Differentail diagnosis: Addison disease, Peutz-Jeghers syndrome, Smoking-associated melanosis, medications that produce pigmentation, physiologic pigmentation, heavy metal pigmentation, and post inflammatory disorders.
Treatment and prognosis: It is benign, but its importance is relevant to being included in the differential diagnoses of pigmentary disorders of the oral mucosa. When cosmetic concerns are voiced, laser surgery is often performed. Patient should be counseled to wear sun-protective clothing and sunscreen daily.
Oral medicine considerations: Laugier-Hunziker is a diagnosis of exclusion of other more serious disease states.
Pg. 369-370