smokers Melanosis

diffuse melanosis of the anterior facial maxillary and mandi- bular gingivae,
buccal mucosa, lateral tongue, palate, and floor of the mouth is occasionally
seen among cigarette smok- ers.
89,90
most smokers (including heavy smokers)
usually fail to show such changes. however, it is probable that in certain
individuals, melanin synthesis is stimulated by tobacco smoke products.
indeed, among dark-skinned individuals who normally exhibit physiologic
pigmentation, smoking stimulates a further increase in oral pigmentation.
91
the pigmented areas are brown, flat, and irregular; some are even geographic
or map-like in configuration.
Melanosis yang menyebar pada gusi bagian fasial anterior maksila dan
mandibular, mukosa bukal, lateral lidah, palatum, dan dasar mulut yang kadang-
kadang terlihat pada perokok. Hampir semua perokok (termasuk perokok berat)
biasanya tidak terlihat perubahan. Namun, kemungkinan masing-masing
individual, sintesis melanin terstimulasi oleh produk asap tembakau. Memang,
diantara individu berkulit gelap yang biasanya menunjukan pigmentasi fisiologis,
merokok dapat merangsang peningkatan pigmentasi di mulut. Area yang
terpigmentasi berwarna coklat, datar, dan tidak beraturan; beberapa terlihat seperti
gambaran peta.
the mechanism by which smoking induces the pigmenta- tion remains
unknown. smokeless tobacco (snuff) does not appear to be associated with an
increase in oral melanosis.
92
thus, it is possible that one or more of the
chemical compounds incorporated within cigarettes, rather than the actual
tobacco, may be causative. another possibility is that the heat of the smoke
may stimulate the pigmentation.
Mekanisme merokok yang membuat pigmentasi masih belum diketahui.
Tembakau tanpa asap (tembakau) tidak terlihat berhubungan dengan peningkatan
melanosis di mulut. Dengan demikian, ada kemungkinan bahwa satu atau lebih
senyawa kimia yang dimasukkan dalam rokok, daripada tembakau yang
sebenarnya, mungkin sebagai penyebabnya. Kemungkinan lain adalah panas dari
asap dapat menstimulasi pigmentasi.




Epidemiologic studies suggest that oral melanosis increases prominently
during the first year of smoking.
92
if there is a reduction in smoking, the
pigmentation may even- tually resolve.
93
histologically, basilar melanosis with
mela- nin incontinence is observed. unlike other smoking-related oral
pathologies, smokers melanosis is not a preneoplastic condition.
Studi epidemiologi menunjukan bahwa oral melanosis meningeal selama tahun pertama
merokok. Jika ada pengurangan merokok, pigmentasi mungkin akhirnya hilang. Tidak
seperti efek merokok pada oral patologi lainnya, smokers melanosis bukanlah kondisi
pre-malignan.

alcohol has also been associated with increased oral pigmentation.
91,94,95
in
alcoholics, the posterior regions of the mouth, including the soft palate, tend
to be more frequently pigmented than other areas. it has been suggested that
alcoholic melanosis may be associated with a higher risk of cancers of the
upper aerodigestive tract.
95

diffuse or patchy melanotic pigmentation is also charac- teristically associated
with oral submucous fibrosis.
94
unlike smokers melanosis, oral submucous
fibrosis is a preneoplas- tic condition caused by habitual chewing of areca
(betel) nut. this custom is common in some East asian cultures. in addi- tion to
the melanosis, increased fibrosis of the oral soft tissues is also characteristic.
oral submucous fibrosis is discussed in more detail in chapter ??.