Faheed al zoabi
Melanocytes have their embryologic orgin in the neural
It is migrate and reside among basal cells .
Melanocytes are found in oral mucosa but go to
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
It is symmetric, persistent & does not alter normal
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.
The lesion is due not to increased numbers of melanocyte
but to increased melanin production.
Etiology & Pathogenesis:
o The lesion is related to a component
o Female sex hormone (as modifiers)
in tobacco smoke that
o Anterior labial gingiva (most commonly affected )
o Palate and buccal mucosa (associated with pipe smoking)
o increased melanin production Similar to that seen in
Treatment: stop of smoking (takes months to years)
is a focal pigmented lesion that may represent:
Associated with Peutz-Jeghers syndrome or Addison’s
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
It is composed of nests of tumor cells with small amount of
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.
They appear shortly after birth & throughout childhood.
Intraoral nevi are rare lesions (<0.5 cm-palate).
o When cells are located in epithelium-connective tissue
junction called Junctional nevus
o When cells are located in connective tissue called
o When cells are located in combination of zone called
o When cells are spindle shaped and found deep in connective
tissue called Blue nevus
White are more affected than blacks
o Skin exposure
o Dark nature pigmentation
o No sex predilection
o Palate and gingiva are most commonly affected
o Irregular margin
Immunotherapy is occasionally used
Prognosis depends on the depth of the lesion
Drug induced pigmentation
Heavy metal pigmentation
It is an iatrogenic lesion that follows traumatic soft tissue
implantation of amalgam particles.
Most common affected site are:
gingiva, buccal mucosa, palate & tongue
Amalgam particles have an affinity for collagen fibers.
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.
Some heavy metal (lead & mercury) may be
responsible for oral pigmentation
deposited of heavy metal in the skin & oral mucosa
given color black to gray.