Pigmented lesions of the oral cavity: review, differential diagnosis, and case presentations.
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Pigmented lesions are commonly found in the mouth. Such lesions represent a variety of clinical entities, ranging from physiologic changes to manifestations of systemic illnesses and malignant neoplasms. Evaluation of a patient presenting with a pigmented lesion should include a full medical and dental history, extraoral and intraoral examinations and, in some cases, biopsy and laboratory investigations. In this paper, an algorithm is proposed for the assessment of pigmented lesions of the oral cavity, and 3 patients with such lesions are described. (+info)
Oral melanoacanthosis (melanoachantoma): report of a case and review of the literature.
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Oral melanoacanthosis (MA) is a rare pigmented mucosal lesion that is considered the counterpart of cutaneous melanoacanthoma. Microscopically the superficial epithelium shows mild to moderate acanthosis, spongiosis and prominent dendritic melanin producing melanocytes, which are present throughout the spinous keratinocytes. Reported cases show predilection for black females and the most common locations in decreasing frequency are buccal mucosa, lip, palate and gingiva. Although its pathogenesis remains uncertain, its clinical behavior is suggestive of a reactive origin. The clinical appearance of oral MA is non diagnostic and therefore biopsy is mandatory to differentiate from other melanocytic lesions, including melanoma. (+info)
Oral melanoacanthoma and oral melanotic macule: a report of 8 cases, review of the literature, and immunohistochemical analysis.
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Oral melanoacanthoma (MA) is a rare, benign pigmented lesion, similar to cutaneous MA, characterized by hyperplasia of spinous keratinocytes and dendritic melanocytes. The pathogenesis of oral MA remains uncertain, although its clinical behavior is suggestive of a reactive origin. The most common intraoral sites are the buccal mucosa, lip, palate and gingiva. The average age of presentation is 28 years, mainly in blacks, with a strong female predilection. The oral melanotic macule (MM) is a small, well-circumscribed brown-to-black macule that occurs on the lips and mucous membranes. The etiology is not clear and it may represent a physiologic or reactive process. The average age of presentation is 43 years, with a female predilection. A biopsy is recommended to distinguish these lesions from each other and from other oral melanocytic lesions. We depict four cases each of oral MA and MM, affecting Caucasian and Latin American mestizo patients. The clinicopathological features of these cases reflect its ample spectrum, and to the best of our knowledge, it is the first example of oral MA affecting a Caucasian boy reported in the English literature. Therefore oral MA and MM should be considered in the differential diagnosis of pigmented lesions in the oral mucosa in these populations. (+info)
Histological changes in intra-oral skin flaps.
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Multifocal diffuse oral melanoacanthoma: a case report.
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Oral melanoacanthoma (OMA) is a rare benign lesion characterized by colonization of acanthotic epithelium by dendritic melanocytes. Although its pathogenenesis remains uncertain, its clinical behavior and spontaneous remission suggest a non-neoplastic nature. Clinically, it may present as a solitary or multifocal lesion; however these two variants exhibit different features. The clinical appearance of OMA is not pathognomonic and biopsy is mandatory. OMA requires no treatment or periodic observation. Here, we report a case of OMA with diffuse lesions also affecting the tongue in a 74-year-old black woman, whose diagnosis was based essentially on clinical and histological features. The immunohistochemical profile is also presented. (+info)
Linear epidermolytic acanthoma of vulva: an unusual presentation.
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Infundibulomatosis: a case report with immunohistochemical study and literature review.
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Tumor of the follicular infundibulum was first described in 1961 by Mehregan and Butler in a patient presenting with multiple papules. It is more frequent, however, as an isolated lesion affecting mainly the face, neck, and upper trunk. Clinical presentation is variable, requiring histology for the diagnosis, which reveals typically a plate-like proliferation of keratinocytes in continuity with the epidermis and hair follicles; some morphological features are reminiscent of the outer root sheath of the hair follicle. A well defined network of elastic fibers surrounding the tumor is usually present using the appropriate staining and this finding is specific because it is not found in other benign follicular tumors. Multiple infundibulomas are usually sporadic and there is no apparent association with internal malignancy. The authors report the case of a 30-year-old female patient with a 5-year history of multiple small discrete hypopigmented macules and papules, scattered over the submental and submaxillary regions and anterior neck. Histopathological findings were consistent with the diagnosis of tumor of the follicular infundibulum. Immunohistochemical study was performed to further characterize the proliferation. (+info)