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pigmented lesions - Coggle Diagram
pigmented lesions
Oral melanoma
Characteristics: the most common affected sites are usually the hard palate and maxillary gingiva. Usually a brown, red, black and even black bluish color and maybe slightly raised with irregular borders. The lesions may have a rapid growth pattern with a deep invasive nature.
Dental implications: intraoral melanoma is a deadly lesion that should be recognized and removed in its earliest stage
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Treatment and prognosis: early detection and treatment art of extreme importance. Oral melanomas are associated with a poor prognosis because of the tendency to metastasized to other organs and tissues. Surgical removal of this lesion is needed for treatment
Etiology: malignant oral melanomas of the head and neck region are rare. The etiology is unknown but tobacco use, chronic irritation, formaldehyde exposure and cytogenic defects may play a role
Physiologic pigmentation
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Dental implications. Some patients complain about the cosmetic factors related to this such as noticeable areas on the gingiva or peri oral tissues
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Etiology: usually found in the gingiva that can occur throughout the mouth. Can occur during pregnancy because of increased levels of hormones. Post menopausal women taking hormone replacement therapy occurrence
Oral melanotic macule
Characteristics: occur on the buccal mucosa and are usually multiple.Usually deep brown blue or black and they are well circumscribed with sharp borders
Dental implications: when changes occur with these lesions such as increased growth or shape there could be a suspicion of a lesion that is characterized by early atypical melanocytes. Biopsy is needed
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Treatment and prognosis: prognosis is excellent and no treatment is needed unless a biopsy is indicated because of changes or there is a question regarding the etiology of the macule
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Amalgam tattoo
Characteristics: amalgam fragments are usually embedded in surrounding tissue during tooth restoration or extractions. The clinical appearance of amalgam tattoo remains within the area that have been previously treated or open wound areas. Opaque fragments of metal are apparent and radiographs where an amalgam tattoo is suspected
Dental implications: the cause of any pigmented area should be determined to roll out serious pathology such as melanoma
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Treatment and prognosis: no treatment is indicated for an amalgam tattoo and the prognosis is excellent
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Nevus or blue nevus
Characteristics: usually found in the pallet whole region to a lesser degree in the buccal mucosa. Maybe seen in shades of gray brown and blue. They are usually well circumscribed and slightly raised.
Dental implications: melanoma is highly malignant and must be treated rapidly and totally removed this could be a suspicion
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Treatment and prognosis: biopsy is performed on the intro oral nervous which is totally removed during surgery. The area in question should be monitored and any subsequent areas should be biopsied as well
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references;
Delong, L & Burkhart, N. (2019). General and Oral Pathology for the Dental Hygienist. Third Edition. Philadelphia: Wolter Kluwer.
Langlais, R, Miller, C., & Gehrig, J. (2017). Color Atlas of Common Oral Diseases. Fifth Edition. Philadelphia: Wolter Kluwer.
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