Pigmented lesions

Melanocytic Clinical features Histopathology DD Treatment

lesion
Physiologic —---- Increased melanin —------- —-----
pigmentation production by melanocytes

Smoking 9 cigarettes cause Increased melanin —--------- Smoking cessation

associated melanosis production by melanocytes
melanosis Anterior labial gingiva
Brown color

Oral melanotic
macule
( focal melanosis )

Cafe au lait Small melanin spots with Increase melanin —---------------- No treatment
macule irregular margins production
6 or more cafe au lait Melanophages
Neurofibromatos represent
is neurofibromatosis

NF1 Size >0.5 cm before

Chromosome puberty
17q 11.2 >1.5 cm after puberty
NF2 Axillary spot ( crowe's
Chromosome sign )
22q 12
Mutations

Pigmented Darkly pigmented mass Alveolar pattern ( nest of —--------------------- Surgical excision
neuroectodermal Childrens cells
tumor of infancy ( Maxilla mandible brain Round oval shaped cells
skull ) are present in connective
tissue

Melanocytic nevus Nevus = mole Junctional nevus ; at —----------- Surgical excision

Size <0.5 cm junction of epithelium and
Skin common connective tissue
Intraoral rare Intradermal nevus ; (most
common )cells are located
in connective tissue
 Compound nevus ; cells
are located in epithelium
and connective tissue
Blue nevus ; cells are
spindle shaped and in
connective tissue

Melanoacanthoma —--------- proliferation of —------------ —------

keratinocytes and
melanocytes localized to
the epidermis.

Melanoma Cutaneous melanoma

Types
Nodular melanoma
Superficial spreading
melanoma
Acral lentiginous
melanoma
Lentigo maligna
melanoma

Two types of growth

Horizontal
Vertical

Oral melanoma
Invasive melanoma ;
vertical growth
In Situ melanoma ;
horizontal growth

Atypical melanocytic
proliferation ; increased
melanocytes with
abnormal morphology