Pigmented lesion


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Oral Pathology I
Third Year

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Pigmented lesion

  1. 1. :Done by Yousef alothman Abdullah alsaad Faheed al zoabi
  2. 2. Melanocytes have their embryologic orgin in the neural crest. It is migrate and reside among basal cells . Melanocytes are found in oral mucosa but go to unnoticed. When focally or generally active in proliferation or production, they produce physiologic pigmentation or can go to malignant neoplasia. Oral melanin range pigmentation from brown to black to blue, depending on amount of melanin produced & depth of pigment.
  3. 3. Physiologic Smoking-associated melanosis Oral melanotic macules Café-au-lait macules Pigmented neuroectodermal tumor of infancy Nevomelanocytic Melanoma
  4. 4.  Clinical features: It is symmetric, persistent & does not alter normal architecture. o Can be seen at any age. o No gender predilection. o Any location (most common in gingiva). o Post-inflammatory pigmentation seen after mucosal reaction to injury. o
  5. 5.  Histopathology: The lesion is due not to increased numbers of melanocyte but to increased melanin production.
  6. 6.  Etiology & Pathogenesis: o The lesion is related to a component stimulate melanocytes o Female sex hormone (as modifiers) in tobacco smoke that  Clinical features: o Anterior labial gingiva (most commonly affected ) o Palate and buccal mucosa (associated with pipe smoking)  Histopathology: o increased melanin production Similar to that seen in physiologic pigmentation.  Treatment: stop of smoking (takes months to years)
  7. 7.  It is a focal pigmented lesion that may represent: 1. 2. 3. Intraoral freckle Postinflammatory pigmentation Associated with Peutz-Jeghers syndrome or Addison’s disease .
  8. 8.  Clinical o o o o o features: It is a benign neoplasm composed of primitive pigment producing cells (neural crest origin) Found in infant Occcurs mainly in the maxilla Nonulcerated & darkely pigmented mass Radiographs shows an-ill defined lucency  Histopathology: It is composed of nests of tumor cells with small amount of connective tissue.  Treatment: Surgical excision
  9. 9.  Nevus is general term that may refer to any congenetal lesion of various cell types or tissue types.  Nevomelanocytic Nevi are collection of nevus cells that are round or polygonal and typically seen in a nested pattern. Can be found in epithelium, connective tissue, or both.  Clinical features: o o They appear shortly after birth & throughout childhood. Intraoral nevi are rare lesions (<0.5 cm-palate).
  10. 10.  Histopathology: o When cells are located in epithelium-connective tissue junction called Junctional nevus o When cells are located in connective tissue called Intramucosal nevus o When cells are located in combination of zone called Compound nevus o When cells are spindle shaped and found deep in connective tissue called Blue nevus
  11. 11. White are more affected than blacks  Predisposing factors: o Skin exposure o Dark nature pigmentation o Nevi  Clinical features: o No sex predilection o Palate and gingiva are most commonly affected o Irregular margin
  12. 12.  Treatment o o o o & prognosis Surgery Chemotherapy Immunotherapy is occasionally used Prognosis depends on the depth of the lesion
  13. 13.  Amalgam tattoo  Drug induced pigmentation  Heavy metal pigmentation
  14. 14.  Etiology:  It is an iatrogenic lesion that follows traumatic soft tissue implantation of amalgam particles.  Clinical features:  Most common affected site are: gingiva, buccal mucosa, palate & tongue  Histopathology:  Amalgam particles have an affinity for collagen fibers.
  15. 15. Tetracycline-associated pigmentation may be found in prolonged treatment with high dose. Other drugs that may produce pigmentation of oral tissue include amino-quinolines, cyclophosphamide, amiodarone & AZT.
  16. 16. Etiology: Some heavy metal (lead & mercury) may be responsible for oral pigmentation Clinical features: deposited of heavy metal in the skin & oral mucosa given color black to gray.
  17. 17. ‫كفو!‬
  18. 18. ‫مياو00!‬