1
|
Oral Melanoacanthoma: Case Series of 33 Cases and Review of the Literature. Head Neck Pathol 2022:10.1007/s12105-022-01506-w. [PMID: 36478543 DOI: 10.1007/s12105-022-01506-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 10/21/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Oral melanoacanthoma (OM) is a rare, reactive, and benign proliferation of two cell types: keratinocytes and melanocytes. Biopsy is mandatory to not only confirm the diagnosis but also, rule out other entities, as clinical correlation simply, is not definitive. AIM OF THE STUDY We present a large series of OM with analysis of demographics, clinical appearance, histologic presentation, and review of the literature. To the best of our knowledge, this is the largest series of oral OM reported to date. MATERIALS AND METHODS Following IRB approval, cases diagnosed as OM within the archives of the University of Florida Oral Pathology Biopsy Service (1998-2020) were included. Patient age, gender, location, clinical appearance, clinical impression, and duration of each lesion was collected. RESULTS A total of 33 cases were included with a mean age of 38.7 years (range of 5-73), and a female: male ratio of 2.6:1. The most common location in descending order was the buccal mucosa (n = 16, 48%), followed by palate (n = 11, 33%), tongue and labial mucosa (n = 2 each, 6%), maxillary and mandibular gingiva (n = 1 each, 3%). The lesions were most frequently brown/black in color, and most often described as macular. All cases were asymptomatic and reported duration was ranged from one week to twelve months. Clinical impression in descending order was pigmented macules (n = 15, 45%), melanosis (n = 4, 12%), nevus (n = 3, 9%), melanoma (n = 2, 6%), melanoacanthoma (n = 1, 3%), and racial pigmentation (n = 1, 3%). Ethnicity was only documented in only 6 out of 33 cases, of which 5 cases were African-American and one Caucasian. The majority of cases (n = 28, 84%) demonstrated hyperplastic/acanthotic surface epithelium with less common, atrophic (n = 4, 12.1%) or spongiotic epithelium (n = 2, 6.06%). CONCLUSION The demographics and clinical presentation of OM in our series was similar to previous findings but encompasses wider variability of histologic presentation. Awareness of OM in the clinical and histologic differential diagnosis of pigmented lesions should be reinforced as many patients are concerned for melanoma and clinicians are often unware of this condition.
Collapse
|
2
|
Aljanobi HA, Alshuyukh MH, Husain MS, Alqahtani WM. Multifocal Intraoral Melanoacanthomas: Two Case Reports and a Literature Review. Cureus 2022; 14:e26946. [PMID: 35989746 PMCID: PMC9380846 DOI: 10.7759/cureus.26946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2022] [Indexed: 11/24/2022] Open
Abstract
Intraoral melanoacanthoma is a rare, reactive pigmented lesion that is mostly seen in black individuals with a tendency to occur more frequently in younger females. The color of melanoacanthoma may vary from brown to black, and it is commonly seen as a solitary lesion in the buccal mucosa. This lesion requires no treatment, and no malignant potential has been observed to date. The clinical presentation of multifocal oral melanoacanthoma (MOMA) (the rate of growth and the recurrence) is usually diagnostic. On the other hand, solitary oral melanoacanthoma might be difficult to diagnose, and a biopsy should be performed and examined by a well-trained oral pathologist. Here, we report two cases of MOMA with an unusual location in one case.
Collapse
|
3
|
Stanbouly D, Canterbury CR, Peters SM. A Pigmented Lesion on the Palate. JAMA Otolaryngol Head Neck Surg 2021; 146:758-759. [PMID: 32584378 DOI: 10.1001/jamaoto.2020.1268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Dani Stanbouly
- Division of Oral and Maxillofacial Pathology, Columbia University College of Dental Medicine, New York, New York
| | - Carleigh R Canterbury
- Division of Oral and Maxillofacial Pathology, Columbia University College of Dental Medicine, New York, New York
| | - Scott M Peters
- Division of Oral and Maxillofacial Pathology, Columbia University College of Dental Medicine, New York, New York
| |
Collapse
|
4
|
Stanbouly D, Shackelford AJ, Peters SM. Diffuse palatal pigmentation. J Am Dent Assoc 2021; 152:1054-1057. [PMID: 33461730 DOI: 10.1016/j.adaj.2020.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/25/2020] [Accepted: 10/12/2020] [Indexed: 10/22/2022]
|
5
|
Datta A, Lamba AK, Tandon S, Urs A, Lnu M. A Unique Presentation of Gingival Melanoacanthoma: Case Report and Review of Literature. Cureus 2020; 12:e7315. [PMID: 32313756 PMCID: PMC7164714 DOI: 10.7759/cureus.7315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Melanoacanthoma is a benign, deeply pigmented condition of the oral mucosa characterized by the proliferation of melanocytes and keratinocytes. A 60-year-old male, with no history of systemic diseases or medical treatment, presented with an asymptomatic diffuse pigmentation involving the maxillary and mandibular gingiva. The histopathology of the anomalous pigmented area was analyzed and the dendritic melanocytes expressed positively for Masson-Fontana, S-100, and HMB-45. The clinical and microscopic findings were indicative of melanoacanthoma. Depigmentation with a diode laser was performed in the areas of esthetic concern. A regular periodic screening was done to rule out any alteration in color, size, and shape. A one-year follow-up disclosed no new lesions. The observations noted in this case are rare, and our literature review identified only a single previously documented case of gingival melanoacanthoma in the Indian subpopulation.
Collapse
Affiliation(s)
- Archita Datta
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | - Arundeep K Lamba
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | - Shruti Tandon
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | - Aadithya Urs
- Oral Pathology and Microbiology, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | - Mahima Lnu
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| |
Collapse
|
6
|
Patel PB, Wright JM, Kang DR, Cheng YSL. Longitudinal clinicopathologic data of the progression of oral mucosal melanoma-report of 2 cases and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 126:e21-e30. [PMID: 29429904 DOI: 10.1016/j.oooo.2017.12.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 12/13/2017] [Accepted: 12/20/2017] [Indexed: 11/27/2022]
Abstract
Oral mucosal melanoma (OMM) is notorious for having a poor prognosis. Recognition of the early features of OMM by both clinicians and pathologists can play an important role in improving survival. Therefore, the purpose of this report is to increase awareness of the early features of OMM, by presenting 2 cases with longitudinal clinical and histopathologic documentation showing progression of OMM from a deceptively bland premalignant (noninvasive) oral melanocytic lesion (POML). By analyzing the clinical and histopathologic features of POML in our cases, and those in the literature, we found that the concerning features are (1) clinically, a pigmented lesion violating the ABCDE criteria or showing multiple recurrences; and (2) histologically, a melanocytic proliferation, in either a lentiginous or pagetoid pattern with or without cellular atypia. Making a diagnosis of POML prospectively is often challenging. Increasing awareness of the clinical and histopathologic features and complete surgical excision of POML are emphasized.
Collapse
Affiliation(s)
- Paras B Patel
- Diagnostic Sciences, Texas A&M University (TAMU) College of Dentistry, Dallas, TX, USA.
| | - John M Wright
- Department of Diagnostic Sciences, TAMU College of Dentistry, Dallas, TX, USA
| | - David R Kang
- Oral and Maxillofacial Surgery, Methodist Health System, Head & Neck Surgery of North Texas, Dallas, TX, USA
| | | |
Collapse
|
7
|
Cantudo-Sanagustín E, Gutiérrez-Corrales A, Vigo-Martínez M, Serrera-Figallo MÁ, Torres-Lagares D, Gutiérrez-Pérez JL. Pathogenesis and clinicohistopathological caractheristics of melanoacanthoma: A systematic review. J Clin Exp Dent 2016; 8:e327-36. [PMID: 27398186 PMCID: PMC4930645 DOI: 10.4317/jced.52860] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 01/08/2016] [Indexed: 01/12/2023] Open
Abstract
Introduction The melanoacanthoma is a rare benign pigmented tumor, characterized by a fast radial growth and clinical behavior similar to melanoma. Color changes in oral mucosa and dermis are consequence of increased melanocyte activity as response to an irritant factor. There is a vast phenotypic variety. It is difficult to distinguish between a benign pigmented lesion and a melanoma at its early stage. Due to its clinical relevance is crucial to diagnose possible malignancy of the lesions. Objectives The aim of this article is to conduct a systematic review of all published articles, as well as update and evaluate etiologic factors and clinicopathological features. Material and Methods We carried out a search in the Medline database (PubMed) using the key words “oral melanoacanthoma” AND “oral melanoacanthosis” AND “oral melanoepithelioma”. Inclusion criteria were all published articles since its discovery. Demographic data, histological features and immunohistochemical findings were extracted from the full articles. Results A total of 56 articles were analysed. 114 injuries drawn from these articles were studied, a total of 115 injuries with our contribution case. The 74.78% of authors claim a reactive pathogenesis. The average age of lesión appearance is 34.79 years, with an age range of 5-87 years. There is a predominance of the female sex in solitary phenotype 3: 2 and a ratio of women to men 5: 3 if it is multifocal phenotype. Bilateral phenotype is slight higher in women of 2: 1. Conclusions Histopathological analysis of the lesión is vital to diagnose malignancy. Therefore, any heterogeneous, pigmented lesion with irregular edges, raised surface, fast growth and abrupt appearance should be biopsied. More emphasis on the potential irritants should also be put to improve the quality of life of our patients and to reduce morbidity of melanoacanthoma, as well as, several similar clinical behavior disease. Key words:Melanoacanthoma, oral cáncer, diagnosis.
Collapse
Affiliation(s)
| | | | - Manuel Vigo-Martínez
- Medical Doctor. Diplomate in Dental Surgery. Lecture in Oral Medicine. University of Seville
| | | | | | | |
Collapse
|
8
|
Andrews BT, Trask DK. Oral Melanoacanthoma: A Case Report, a Review of the Literature, and a New Treatment Option. Ann Otol Rhinol Laryngol 2016; 114:677-80. [PMID: 16240929 DOI: 10.1177/000348940511400904] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: Oral melanoacanthoma is a rare condition that presents as a pigmented, painful lesion, most commonly on the buccal mucosa. Argon plasma coagulation is a new treatment option for benign oral lesions and is hypothesized to be efficacious for this rare mucosal disorder. Methods: Treatment of a case and a review of the English-language literature were performed. Results: One patient received a diagnosis of oral melanoacanthoma, and argon plasma coagulation treatment resulted in ablation of the lesion with excellent mucosal healing. A review of the literature demonstrated that this lesion is most commonly associated with black (90.9%), adult female (69.7%) patients and is most commonly located on the buccal mucosa (64.7%). Conclusions: Oral melanoacanthoma is a rare, benign mucosal lesion that may require surgical intervention for symptomatic relief. Argon plasma coagulation is a relatively safe and effective means of treating this lesion. Argon plasma coagulation treatment may be expanded to include other benign, superficial lesions of the oral mucosa.
Collapse
Affiliation(s)
- Brian T Andrews
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA
| | | |
Collapse
|
9
|
Diagnosis of oral pigmentations and malignant transformations. ACTA ACUST UNITED AC 2014; 35C:39-46. [PMID: 25496584 DOI: 10.1016/j.sdj.2014.03.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 12/04/2013] [Accepted: 03/05/2014] [Indexed: 01/24/2023]
Abstract
BACKGROUND Oral pigmentation is a common finding in the mouth. Pigmentation can be either normal or abnormal discoloration of oral mucous membrane. The purpose of this review mainly focuses on the main oral pigmented lesions, in order to help the clinicians establish a better approach towards the patients with pigmented oral lesions and to provide thorough knowledge regarding such lesions for patient reassurance, early definitive diagnosis and prompt treatment. METHODS Relevant data concerning oral pigmented lesions, clinical features and the possibility of malignant transformation of such lesions were reviewed thoroughly from pubmed literature published in English. Pigmented lesions affecting the skin were not included in our review. RESULTS Few pigmented lesions have been identified and their tendency to become malignant has been reported in the literature. The oral lesions showing malignant transformation reported were mostly case series. Unfortunately, due to lack of long-term studies, follow ups and randomized controlled studies in this respect it was difficult to draw a statistical analysis. This information is quite crucial for general dental practitioners to improve their understanding regarding oral lesions and to differentiate between normal and diseased conditions, so that they can master the skill of differential diagnosis, definitive diagnosis and prompt treatment. CONCLUSION Oral pigmentation may present as focal, multifocal or diffused macular or tumefactive lesions. They may greatly vary in color as blue, purple, brown, gray or black depending on the quantity and site of melanin in the tissues [1]. Etiology of pigmentation can be multi factorial. Mostly pigmentation is physiologic but at times it can be a precursor of severe diseases. Lesions may be caused by localized harmless accumulations of melanin, hemosiderin or exogenous metals or they may be a sign of underlying systemic or genetic disease. A few lesions may be associated with life-threatening medical conditions that require immediate intervention. The differential diagnosis for any pigmented lesion is extensive, as it includes examples of endogenous and exogenous pigmentations. Although biopsy is a helpful and necessary aid in the diagnosis of focally pigmented lesions, with diffuse pigmentation lesions require a thorough dental and medical history and laboratory investigations.
Collapse
|
10
|
Matsumoto N, Kitano T, Oki H, Omagari D, Matsue Y, Okudera M, Yamamura T, Nishikawa Y, Nishimura S, Asano M, Komiyama K. Pigmented oral carcinoma in situ: a case report and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:e79-83. [PMID: 24746807 DOI: 10.1016/j.oooo.2014.01.230] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Revised: 01/22/2014] [Accepted: 01/31/2014] [Indexed: 11/25/2022]
Abstract
Oral melanotic lesions, including melanin pigmentation, melanocytic nevus, and malignant melanoma, are well-recognized pathologic entities. However, melanocytic proliferation within malignant oral mucosal lesions is not well documented. We report the unusual case of a 53-year-old Japanese man who developed oral carcinoma in situ (CIS) with melanocytic proliferation and melanin pigmentation in the epithelial layer. The patient, a nonsmoker and an opportunistic drinker, presented with a brown tongue lesion. Initial examination found a large brown pigmented area and multiple small white patchy areas on the right tongue border. The pigmentation had an ill-defined border with uneven color distribution. Physical examination found no abnormalities. Ultrasonography did not find a deeply infiltrating lesion. Oral mucosal malignant melanoma in situ was diagnosed, and partial tongue resection was performed. Histopathologic examination found oral pigmented CIS. To the best of our knowledge, this is only the third reported case of oral pigmented CIS.
Collapse
Affiliation(s)
- Naoyuki Matsumoto
- Assistant Professor, Department of Pathology, Nihon University School of Dentistry, Tokyo, Japan.
| | - Taiichi Kitano
- Postgraduate student, Department of Pathology, Nihon University School of Dentistry, Tokyo, Japan
| | - Hidero Oki
- Professor, Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry, Tokyo, Japan
| | - Daisuke Omagari
- Postdoctoral Fellow, Department of Pathology, Nihon University School of Dentistry, Tokyo, Japan
| | - Yasuyoshi Matsue
- Postgraduate student, Department of Pathology, Nihon University School of Dentistry, Tokyo, Japan
| | - Michisato Okudera
- Postgraduate student, Department of Pathology, Nihon University School of Dentistry, Tokyo, Japan
| | - Takashi Yamamura
- Postgraduate student, Department of Pathology, Nihon University School of Dentistry, Tokyo, Japan
| | - Yohichi Nishikawa
- Postgraduate student, Department of Pathology, Nihon University School of Dentistry, Tokyo, Japan
| | - Satoshi Nishimura
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry, Tokyo, Japan
| | - Masatake Asano
- Associate Professor, Department of Pathology, Nihon University School of Dentistry, Tokyo, Japan
| | - Kazuo Komiyama
- Professor, Department of Pathology, Nihon University School of Dentistry, Tokyo, Japan
| |
Collapse
|
11
|
Rohilla K, Ramesh V, Balamurali P, Singh N. Oral melanoacanthoma of a rare intraoral site: case report and review of literature. Int J Clin Pediatr Dent 2013; 6:40-3. [PMID: 25206187 PMCID: PMC4034627 DOI: 10.5005/jp-journals-10005-1185] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 03/14/2013] [Indexed: 11/30/2022] Open
Abstract
Oral melanoacanthoma is rare pigmented mucosal lesion that presents most commonly on the buccal mucosa, characterized by sudden appearance and rapid radial growth, thus clinically mimicking malignant melanoma. It was originally described as a mixed tumor of melanocytes and keratinocytes, but appears to be a reactive process; formed in areas prone to trauma, and regressing after the removal of trauma or incomplete excision. The clinical appearance of oral melanoacanthoma is nondiagnostic, and biopsy is mandatory to rule out malignancy. We report a case of melanoacanthoma of a rarer oral mucosal site in a 12-year-old Asian male. A brief review of the current literature is also presented. How to cite this article: Rohilla K, Ramesh V, Balamurali PD, Singh N. Oral Melanoacanthoma of a Rare Intraoral Site: Case Report and Review of Literature. Int J Clin Pediatr Dent 2013;6(1):40-43.
Collapse
Affiliation(s)
- Kshitiz Rohilla
- Demonstrator, Department of Oral Pathology, Postgraduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - V Ramesh
- Dean, Professor and Head, Department of Oral Pathology and Microbiology, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Puducherry, India
| | - Pd Balamurali
- Professor, Department of Oral Pathology and Microbiology, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Puducherry, India
| | - Namrata Singh
- Ex-Senior Lecturer, Department of Orthodontics and Dentofacial Orthopedics, Indira Gandhi Institute of Dental Sciences, Puducherry India
| |
Collapse
|
12
|
Hegde N, Hegde MN. Internal and external root resorption management: a report of two cases. Int J Clin Pediatr Dent 2013; 6:44-7. [PMID: 25206188 PMCID: PMC4034642 DOI: 10.5005/jp-journals-10005-1186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 03/14/2013] [Indexed: 11/23/2022] Open
Abstract
The response of the dentoalveolar apparatus to infection is characterized by inflammation which may result in tooth resorption. Depending upon the type of resorption and etiology, different treatment regimens have been proposed. The following two cases demonstrate internal and external inflammatory root resorption arrest by conventional nonsurgical endodontic therapy combined with calcium hydroxide-iodoform dressing, mineral trioxide aggregate (MTA) and flowable gutta-percha system.The patient has been regularly recalled every 6 months and radiographically the apical lesion showed signs of healing and arrest of root resorption after 1 year and 6 months. How to cite this article: Hegde N, Hegde MN. Internal and External Root Resorption Management: A Report of Two Cases. Int J Clin Pediatr Dent 2013;6(1):44-47.
Collapse
Affiliation(s)
- Nanditha Hegde
- Assistant Professor, Father Muller Medical College, Mangalore Karnataka, India
| | - Mithra N Hegde
- Senior Professor and Head, Department of Conservative Dentistry and Endodontics, AB Shetty Memorial Institute of Dental Sciences Mangalore, Karnataka, India
| |
Collapse
|
13
|
das Chagas E Silva de Carvalho LF, Farina VH, Cabral LAG, Brandão AAH, Coletta RD, Almeida JD. Immunohistochemical features of multifocal melanoacanthoma in the hard palate: a case report. BMC Res Notes 2013; 6:30. [PMID: 23356913 PMCID: PMC3568418 DOI: 10.1186/1756-0500-6-30] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 01/24/2013] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Melanoacanthoma (MA) has been described in the oral mucosa as a solitary lesion or, occasionally, as multiple lesions. MA mainly affects dark skinned patients and grows rapidly, showing a plane or slightly raised appearance and a brown to black color. The differential diagnosis includes oral nevi, amalgam tattoos, and melanomas. We report here the case of a 58-year-old black woman who presented multiple pigmented lesions on the hard palate. CASE PRESENTATION Based on the differential diagnosis of melanoma, a punch biopsy (4 mm in diameter) was performed. The material was fixed in 10% formalin, embedded in paraffin, and stained with hematoxylin-eosin or submitted to immunohistochemical analysis. Immunohistochemistry using antibodies against protein S-100, melan-A, HMB-45, MCM-2, MCM-5, Ki-67 and geminin was performed. Immunohistochemical analysis revealed strong cytoplasmic immunoreactivity of dendritic melanocytes for proteinS-100, HMB-45 and melan-A.Positive staining for proliferative markers (MCM-2, MCM-5, Ki-67) was only observed in basal and suprabasal epithelial cells, confirming the reactive etiology of the lesion. The diagnosis was oral Melanoacanthoma (MA). CONCLUSION The patient has been followed up for 30 months and shows no clinical alterations. MA should be included in the differential diagnosis of pigmented lesions of the oral cavity.
Collapse
|
14
|
Sharma NS. Management of a growing Skeletal Class II Patient: A Case Report. Int J Clin Pediatr Dent 2013; 6:48-54. [PMID: 25206189 PMCID: PMC4034635 DOI: 10.5005/jp-journals-10005-1187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Accepted: 03/14/2013] [Indexed: 11/23/2022] Open
Abstract
Sagittal and transverse discrepancies often coexist in skeletal class II malocclusions. Orthopedic growth modification can work well in such cases, provided that the remaining pubertal growth is adequate and that the clinician can provide timely treatment to coincide with the peak growth period. The transverse discrepancy is generally corrected first, establishing a proper base for the sagittal correction to follow. For example, in a skeletal class II case with a narrow maxillary arch and retrusive mandible, maxillary expansion is performed initially to facilitate functional mandibular advancement. The present article illustrates an exception to this rule, in a case where sagittal correction was undertaken before transverse correction to make optimal use of the patient's pubertal growth spurt in first phase followed by a second phase of fixed appliance therapy during adolescence to achieve optimal results. How to cite this article: Sharma NS. Management of a growing Skeletal Class II Patient: A Case Report. Int J Clin Pediatr Dent 2013;6(1):48-54.
Collapse
Affiliation(s)
- Narendra Shriram Sharma
- Assistant Professor, Department of Orthodontia, SP Dental College and Hospital, Wardha, Maharashtra, India
| |
Collapse
|
15
|
Woo SB. Diseases of the oral mucosa. MCKEE'S PATHOLOGY OF THE SKIN 2012:362-436. [DOI: 10.1016/b978-1-4160-5649-2.00011-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
|
16
|
Woo SB. Pigmented Lesions. ORAL PATHOLOGY 2012:185-209. [DOI: 10.1016/b978-1-4377-2226-0.00009-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
|
17
|
Multifocal oral melanoacanthoma and melanotic macula in a patient after dental implant surgery. J Am Dent Assoc 2011; 142:817-24. [PMID: 21719804 DOI: 10.14219/jada.archive.2011.0270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Oral melanoacanthoma (OMA) is an uncommon, reactive, pigmented mucocutaneous lesion. It is a rapidly growing, well-circumscribed, small, brown-to-black, solitary or multifocal macule that is characterized histopathologically by proliferation of keratinocytes and pigment-laden dendritic melanocytes. CASE DESCRIPTION At the end of a one-month healing period after dental implant surgery, a 63-year-old white woman had pigmented lesions at different oral mucosal sites (hard palate, buccal mucosa and left maxillary tuberosity) that showed macrophages exhibiting iron and melanin in multiple areas of the lamina propria. The authors obtained biopsy specimens from all the lesions for histologic and immunohistochemical analyses and light-microscopy study. CONCLUSIONS AND CLINICAL IMPLICATIONS Surgery could have been causal or incidental to the appearance of these lesions. Clinicians should be aware of this possible event and make a correct and pathologically confirmed differential diagnosis.
Collapse
|
18
|
Abstract
The etiopathogenesis of oral pigmentation is diverse. One such process is the oral melanoacanthoma, a reactive, melanocytic lesion, infrequently found in the pediatric subpopulation. To extend the knowledge of this lesion, we provide a case of gingival melanoacanthoma in a 17-year-old male patient. In addition, a comprehensive differential diagnosis for gingival hyperpigmentations in young patients is detailed.
Collapse
Affiliation(s)
- John K Brooks
- Department of Oncology and Diagnostic Sciences, University of Maryland Dental School, Baltimore, Maryland 21201-1586, USA.
| | | | | |
Collapse
|
19
|
Brooks JK, Sindler AJ, Papadimitriou JC, Francis LAP, Scheper MA. Multifocal melanoacanthoma of the gingiva and hard palate. J Periodontol 2009; 80:527-32. [PMID: 19254138 DOI: 10.1902/jop.2009.080496] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Gingival melanoacanthoma is an uncommon reactive lesion, typically appearing as a solitary pigmented macule. This article reports a previously undescribed case of multifocal melanoacanthoma affecting the maxillary and mandibular gingiva and the hard palate. A literature review of melanoacanthoma of the gingiva is also provided. METHODS An otherwise healthy 60-year-old white female sought care for a periodic dental prophylaxis. The intraoral examination was remarkable for numerous painless, brown macular lesions in all four gingival quadrants and on the hard palate (eight on the gingiva and six on the palate). The lesions ranged in size from 2 to 4 mm. The patient had only been aware of one of these lesions, estimating its existence to be <1-year duration. The unusual and widespread presentation of these lesions warranted biopsy. RESULTS On microscopy, all surgical specimens revealed an acanthotic population of epithelium, with dendritic melanocytes distributed throughout, and numerous melanophages contained in the connective tissue. The dendritic melanocytes were immunoreactive for HMB-45 and S-100. Ultrastructural studies confirmed the presence of keratinocytes and dendritic melanocytes containing melanosomes. A 5.5-month follow-up recall disclosed six new pigmented lesions (four on the gingiva and two on the hard palate), clinically identical to the previously discerned melanoacanthomas. There has been no recurrence of any of the biopsied lesions. CONCLUSIONS Gingival melanoacanthomas may present as a solitary lesion or involve multiple sites. Pigmented gingival lesions of recent origin and without etiologic factors should undergo histopathologic review. A conservative biopsy for gingival melanoacanthoma may be sufficient for lesion identity and definitive treatment.
Collapse
Affiliation(s)
- John K Brooks
- Department of Oncology and Diagnostic Sciences, Baltimore College of Dental Surgery, Dental School, University of Maryland, Baltimore, 650 W. Baltimore St., Baltimore, MD 21201-1586, USA.
| | | | | | | | | |
Collapse
|
20
|
Lakshminarayanan V, Ranganathan K. Oral melanoacanthoma: a case report and review of the literature. J Med Case Rep 2009; 3:11. [PMID: 19144105 PMCID: PMC2631493 DOI: 10.1186/1752-1947-3-11] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Accepted: 01/13/2009] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Oral melanoacanthoma is a rare, benign pigmented lesion characterized clinically by the sudden appearance and rapid growth of a macular brown-black lesion and histologically by acanthosis of the superficial epithelium and proliferation of dendritic melanocytes. CASE PRESENTATION We present a case report of oral melanoacanthoma in a 24-year-old Asian Indian man. He presented with an intra-oral brown macular lesion on the left buccal mucosa with a duration of one and a half months. Microscopic examination revealed acanthosis of stratified squamous surface epithelium and dendritic melanocytes diffusely distributed in the epithelium; the Masson-Fontana silver impregnation technique was used to demonstrate the dendritic melanocytes. Based on the history, clinical features and histological presentation, the lesion was diagnosed as melanoacanthoma. CONCLUSION This is the first reported instance of oral melanoacanthoma in the Indian sub-continent. This report details the course of the lesion from diagnosis to its resolution. Melanoacanthoma must be differentiated from other intra-oral pigmented lesions and biopsy may be required to rule out melanoma.
Collapse
Affiliation(s)
- Vidya Lakshminarayanan
- Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, East Coast Road, Chennai, Tamilnadu 600119, India.
| | | |
Collapse
|
21
|
Lerman MA, Karimbux N, Guze KA, Woo SB. Pigmentation of the hard palate. ACTA ACUST UNITED AC 2008; 107:8-12. [PMID: 18801675 DOI: 10.1016/j.tripleo.2008.07.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Revised: 07/16/2008] [Accepted: 07/17/2008] [Indexed: 10/21/2022]
Affiliation(s)
- Mark A Lerman
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts 02115, USA.
| | | | | | | |
Collapse
|
22
|
|
23
|
Cheng AG, Deubner H, Whipple ME. Melanoacanthoma of the external auditory canal: a case report and review of the literature. Am J Otolaryngol 2007; 28:433-5. [PMID: 17980780 DOI: 10.1016/j.amjoto.2006.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2006] [Revised: 11/07/2006] [Accepted: 11/16/2006] [Indexed: 11/16/2022]
Affiliation(s)
- Alan G Cheng
- Department of Otolaryngology-Head and Neck Surgery, University of Washington Medical Center, Seattle, WA 98195, USA.
| | | | | |
Collapse
|
24
|
Treister NS, Magalnick D, Woo SB. Oral mucosal pigmentation secondary to minocycline therapy: report of two cases and a review of the literature. ACTA ACUST UNITED AC 2004; 97:718-25. [PMID: 15184854 DOI: 10.1016/j.tripleo.2003.11.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Minocycline is a semisynthetic broad-spectrum antimicrobial agent that was first introduced into clinical practice in 1967. The most common use of minocycline is for the long-term treatment of acne vulgaris. A well-recognized side effect of minocycline treatment is pigmentation, which has been reported in multiple tissues and fluids including thyroid, skin, nail beds, sclera, bone, and teeth. While there have been several reports of oral pigmentation following minocycline therapy, these have been, for the most part, pigmentation of the underlying bone with the overlying oral mucosa only appearing pigmented. We report two cases of actual pigmented oral mucosal lesions on the hard palate secondary to minocycline therapy with the accompanying histopathology, followed by a discussion of minocycline-induced oral pigmentation and a differential diagnosis of these lesions.
Collapse
Affiliation(s)
- Nathaniel S Treister
- Department of Oral Medicine, Infection, and Immunity, Harvard University School of Dental Medicine, Boston, MA, USA.
| | | | | |
Collapse
|
25
|
Abstract
Skin cancer prevalence in ethnic skin is low. Squamous cell carcinoma, hypopigmented mycosis fungoides, and acral lentiginous melanoma are the most serious types of skin cancer noted in the darker-skinned population. Photoaging occurs less frequently and is less severe in ethnic skin.
Collapse
Affiliation(s)
- Rebat M Halder
- Departament of Dermatology, Howard University College of Medicine, 2041 Georgia Avenue, NW, Washington, DC 20060, USA
| | | |
Collapse
|
26
|
Fornatora ML, Reich RF, Haber S, Solomon F, Freedman PD. Oral melanoacanthoma: a report of 10 cases, review of the literature, and immunohistochemical analysis for HMB-45 reactivity. Am J Dermatopathol 2003; 25:12-5. [PMID: 12544093 DOI: 10.1097/00000372-200302000-00003] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Oral melanoacanthoma (MA) is rare reactive mucosal lesion that, like cutaneous MA, demonstrates hyperplasia of spinous keratinocytes and melanocytes. Unlike MA of the skin, oral MA is unrelated to seborrheic keratosis. This series adds 10 cases to the limited number of previous reports of oral MA. The clinicopathologic features of the cases in this series are generally consistent with those previously reported in the literature; that is, although documented in various intraoral locations in patients of differing ethnicity, oral melanoacanthoma most often presents as an enlarging flat or slightly raised area of hyperpigmentation on the buccal mucosa of adult black women. The current series provides evidence of occurrence over a wider age range (5-77 years) than previously reported. Additionally, the reactivity of oral melanoacanthoma to HMB-45 was investigated. Strong HMB-45 reactivity was present in all cases, thus demonstrating its limited utility in distinguishing oral MA from malignant melanoma.
Collapse
Affiliation(s)
- Maria L Fornatora
- Department of Oral and Maxillofacial Pathology, Medicine and Surgery, Temple University School of Dentistry, Philadelphia, Pennsylvania 19140-5096, USA.
| | | | | | | | | |
Collapse
|
27
|
Fatahzadeh M, Sirois DA. Multiple intraoral melanoacanthomas: a case report with unusual findings. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 94:54-6. [PMID: 12193894 DOI: 10.1067/moe.2002.122337] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Melanoacanthoma is a rare, benign, mucocutaneous pigmented lesion characterized by colonization of acanthotic epithelium by dendritic melanocytes.(1,2) The most common intraoral sites are the buccal(3,4) and masticatory mucosa subject to chronic irritation.(1,5) The pathogenesis of oral melanoacanthoma remains uncertain, although its clinical behavior is suggestive of a reactive cause.(3,4,6,7) The clinical appearance of melanoacanthoma is nondiagnostic, and biopsy is mandatory.(2,3,5,6,8) The lesion, however, requires no treatment(5) and elimination of local irritants as well as periodic observation are the recommended interventions.(1,8) We describe a 39-year-old black patient with a recently reported palatal melanoacanthoma who developed additional lesions in other intraoral sites approximately 3 months after the initial lesion was biopsied. This article also documents the reactive and reversible nature of intraoral melanoacanthoma in a rare case of multiple lesions.
Collapse
Affiliation(s)
- Mahnaz Fatahzadeh
- Department of Diagnostic Sciences, Division of Oral Medicine, New Jersey Dental School, University of Medicine & Dentistry of New Jersey, 110 Bergen Street-D885, Newark, NJ 07103, USA
| | | |
Collapse
|
28
|
Affiliation(s)
- Giovanni M Gaeta
- Department of Oral Medicine Pathology, School of Dentistry, Second University of Naples, Naples, Italy
| | | | | |
Collapse
|
29
|
Friedman IS, Shelton RM, Phelps RG. Minocycline-induced hyperpigmentation of the tongue: successful treatment with the Q-switched ruby laser. Dermatol Surg 2002; 28:205-9. [PMID: 11896769 DOI: 10.1046/j.1524-4725.2002.01083.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Minocycline-induced hyperpigmentation (MIH) is a benign condition that may persist for years despite abrogation of therapy. The Q-switched ruby laser (QSRL) has been successful in removing such lesions from the skin. To date there is no documentation of QSRL or any laser being used to treat lingual hyperpigmentation associated with minocycline therapy. OBJECTIVE Long-term follow-up results are reported for the use of QSRL to treat lingual hyperpigmentation. The literature is reviewed comparing the use of different laser systems on MIH. METHODS A 26-year-old woman with pigment changes of the tongue and buccal mucosa due to long-term minocycline therapy was treated with four consecutive sessions with QSRL (694 nm, 20-nsec pulse duration, and 6.5 mm spot size) at 3.6-4.0 J/cm2. RESULTS A 90% resolution was achieved after three treatments. After the final treatment the lesions were completely gone. There were no side effects reported. No new pigment was detected at follow-up. CONCLUSION Treatment with the QSRL is a safe and effective strategy for treating hyperpigmentation of the tongue associated with minocycline therapy.
Collapse
Affiliation(s)
- Ilyse S Friedman
- Department of Dermatology, Mount Sinai Medical Center, New York, New York 10009, USA
| | | | | |
Collapse
|
30
|
Minocycline-Induced Hyperpigmentation of the Tongue. Dermatol Surg 2002. [DOI: 10.1097/00042728-200203000-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
31
|
Abstract
Oral pigmentation may be physiological or pathological in nature. It may represent a localized anomaly of limited significance or the presentation of potentially life-threatening multisystem disease. Evaluation of a patient with oral pigmentation requires a systematic approach with resource to appropriate investigations in certain circumstances. A full history of evolution of the pigmentary changes, as well as inquiring into family history, drug ingestion and systemic symptoms of concurrent disease are clearly important in the assessment. The duration, pattern, hue and distribution of colour changes can provide useful diagnostic clues. Special attention is given to newly appearing lesions, or those that have changed significantly in appearance, and biopsy may be needed to validate the clinical impression. This review should enable the reader to increase their familiarity with the assessment of oral pigmentation, the common causes of oral pigmentary change and the rarer disorders of pigmentation seen in this area. The systemic diseases that may give rise to oral pigmentation are detailed and the early signs of oral melanoma are highlighted, as well as the drugs which may cause pigmentary changes in this area and the different pattern of pigmentation they may induce.
Collapse
Affiliation(s)
- P Lenane
- Regional Centre of Dermatology Mater Misericordiae Hospital, Dublin, Ireland
| | | |
Collapse
|
32
|
Abstract
The vast majority of healthy individuals have some form of melanocytic lesions with most having several cutaneous melanocytic nevocellular nevi. The incidence of cutaneous melanoma, despite improved prevention and early diagnosis of precursor melanocytic lesions, is on the increase with a projection that one in 75 persons born in the year 2000 will develop cutaneous melanoma in his/her lifetime. With cutaneous melanoma, the number, location and type of nevi, sun exposure and inability to tan, and presence or absence of dysplastic nevi affect transformation to a malignant process. Certain familial factors, syndromes, cytogenetic abnormalities, and mutations in tumor suppressor genes also influence tumor formation. In contrast, mucosal melanoma involving the oral cavity and head and neck regions is not as well understood or characterized. No doubt, this is due to the fact that this subtype of melanoma accounts for less than 1% of all cases. Mucosal melanomas tend to present at a higher stage, are more aggressive, and in a vertical growth phase of disease. A definitive precursor lesion for mucosal melanoma has not been identified; however, atypical melanocytic hyperplasia may represent a proliferative phase before overt tumorigenesis occurs. Melanoma-related antigens, growth factors, and proliferation markers have been identified in cutaneous melanoma, and allow for development of immunotherapy directed against melanoma-associated entities. It is currently possible to evaluate the cytogenetic make-up of precursor melanocytic lesions and frank melanoma, and the constitutional genetic background of individuals at risk for melanoma. No doubt, as concerted investigations of mucosal melanomas of the oral cavity and head and neck evolve, similar factors will be identified which will direct therapy and predict recurrence and survival. In the not too distant future, innovative retroviral transfection, antibodies against specific melanoma-associated factors, vaccination against melanoma, and gene therapy to repair cytogenetic abnormalities and tumor suppressor gene mutations may provide effective therapy and protection against melanomas.
Collapse
Affiliation(s)
- M J Hicks
- Director of Surgical and Ultrastructural Pathology, Department of Pathology, MC1-2261, Baylor College of Medicine, Texas Childrens Hospital, 6621 Fannin Street, Houston, TX 77030-2399, USA.
| | | |
Collapse
|
33
|
Chandler K, Chaudhry Z, Kumar N, Barrett AW, Porter SR. Melanocanthoma: a rare cause of oral hyperpigmentation. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1997; 84:492-4. [PMID: 9394380 DOI: 10.1016/s1079-2104(97)90264-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The oral features of a black woman with melanocanthoma of the oral mucosa are detailed, and the current literature of melanocanthoma of the oral mucosa is briefly reviewed.
Collapse
Affiliation(s)
- K Chandler
- Department of Oral Medicine, Eastman Dental Institute for Oral Health Care Sciences University of London, UK
| | | | | | | | | |
Collapse
|
34
|
Landwehr DJ, Halkias LE, Allen CM. A rapidly growing pigmented plaque. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1997; 84:332-4. [PMID: 9347492 DOI: 10.1016/s1079-2104(97)90026-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- D J Landwehr
- College of Dentistry, Ohio State University, Columbus, USA
| | | | | |
Collapse
|
35
|
Gould AR, Steiner M, Kushner GM, Goldberg JS. Pigmented macule of the hard palatal mucosa. J Oral Maxillofac Surg 1997; 55:282-6. [PMID: 9054918 DOI: 10.1016/s0278-2391(97)90543-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- A R Gould
- Department of Surgical and Hospital Dentistry, School of Dentistry, University of Louisville KY 40292, USA
| | | | | | | |
Collapse
|
36
|
Abstract
This article presents a review of oral malignant melanoma and other oral cavity pigmented lesions. The dismal prognosis for patients with oral malignant melanoma is partly due to patients' delayed recognition of signs of early disease and delayed diagnosis by physicians. Pigmented macules and plaques in the oral cavity, representing the radial growth phase of tumors, often go unrecognized for months or years before tumor invasion. Therefore, if early detection of thin oral melanomas is to be achieved, all pigmented oral cavity lesions should be viewed with suspicion. Biopsies of such lesions are indicated when the clinical diagnosis is uncertain. Prompt aggressive surgical treatment is essential in reducing the morbidity and mortality from oral melanomas. The differential diagnosis of oral melanomas includes nevi, oral melanotic macules, amalgam tattoos, Kaposi's sarcoma, oral melanoacanthoma, and physiologic pigmentation.
Collapse
Affiliation(s)
- D Eisen
- Department of Dermatology, University of Michigan, Ann Arbor
| | | |
Collapse
|
37
|
Buchner A, Merrell PW, Hansen LS, Leider AS. Melanocytic hyperplasia of the oral mucosa. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1991; 71:58-62. [PMID: 1994324 DOI: 10.1016/0030-4220(91)90522-e] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Lesions that exhibit melanocytic hyperplasia are uncommon in the oral mucosa. They are even more rare than the various morphologic types of nevomelanocytic lesions. This article reports the clinicopathologic features of oral lesions diagnosed as lentigo simplex, junctional lentigo ("jentigo"), atypical melanocytic hyperplasia (melanoma in situ), and melanocanthoma. The proper terminology for these lesions is also discussed.
Collapse
Affiliation(s)
- A Buchner
- Division of Oral Pathology, School of Dentistry, University of the Pacific, San Francisco
| | | | | | | |
Collapse
|
38
|
Tomich CE, Zunt SL. Melanoacanthosis (melanoacanthoma) of the oral mucosa. THE JOURNAL OF DERMATOLOGIC SURGERY AND ONCOLOGY 1990; 16:231-6. [PMID: 2179347 DOI: 10.1111/j.1524-4725.1990.tb03958.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A pigmented lesion of the oral mucosa that bears histologic resemblance to the cutaneous melanoacanthoma is discussed. A study of 22 cases, including 4 in the current series, shows that the intraoral lesion occurs most commonly in adult black women on the buccal mucosa and lip. The lesion is known to regress. The term melanoacanthosis is suggested for this condition.
Collapse
Affiliation(s)
- C E Tomich
- Department of Oral Pathology, Indiana University School of Dentistry, Indianapolis
| | | |
Collapse
|
39
|
Abstract
Oral melanoacanthoma is a rarely-reported, benign pigmented lesion of oral mucosa. Spongiosis was only recently mentioned as a light-microscopical finding occasionally seen in oral melanoacanthoma, and the formation of spongiotic intraepithelial vesicles to our knowledge has never been reported. The authors discuss a case of a 34-year-old, black woman who acutely developed extensive hyperpigmented oral lesions which on the biopsy showed both intraepithelial dendritic melanocytes and severe spongiosis forming intraepithelial vesicles. These lesions resolved spontaneously in a few months which led the authors to believe that the term melanoacanthoma, implying that it is a tumor, is a misnomer. This report supports findings of other investigators who consider oral melanoacanthoma to be a mucositis with unusual proliferation of dendritic melanocytes in the epidermis.
Collapse
Affiliation(s)
- A Zemtsov
- Department of Dermatology, Cleveland Clinic Foundation, Ohio
| | | |
Collapse
|
40
|
Horlick HP, Walther RR, Zegarelli DJ, Silvers DN, Eliezri YD. Mucosal melanotic macule, reactive type: a simulation of melanoma. J Am Acad Dermatol 1988; 19:786-91. [PMID: 3056992 DOI: 10.1016/s0190-9622(88)70235-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Two patients with spontaneously resolving hyperpigmented patches of the oral mucosa are reported. Histologically, lesions in both cases showed large pigment-laden dendritic cells singly dispersed at all levels of the epidermis, which simulated in situ melanoma. The absence of such cells in the basal layer of the epidermis served to histologically distinguish these lesions from a biologically malignant melanocytic tumor. Spontaneous resolution in both patients suggests that the condition is reactive. We propose the term mucosal melanotic macule, reactive type, for this lesion, which has been described previously under the misnomer oral melanoacanthoma.
Collapse
Affiliation(s)
- H P Horlick
- Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York, NY 10032
| | | | | | | | | |
Collapse
|
41
|
Whitt JC, Jennings DR, Arendt DM, Vinton JR. Rapidly expanding pigmented lesion of the buccal mucosa. J Am Dent Assoc 1988; 117:620-2. [PMID: 3254175 DOI: 10.14219/jada.archive.1988.0065] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A case of oral melanoacanthoma was presented. The differential diagnosis of pigmented lesions of the oral mucous membrane includes a wide variety of categories of disease including local and systemic manifestations of hereditary and developmental conditions, reactive and inflammatory lesions, neoplasms, and metabolic diseases. For some of these lesions the histopathological pattern is diagnostic; for others, the tissue structure and organization are nonspecific and intelligent evaluation requires clinicopathological correlation. This discussion of oral mucosal pigmented lesions emphasizes the importance of the clinical parameters in the differential diagnosis of this group of lesions.
Collapse
Affiliation(s)
- J C Whitt
- Laboratory Department, Naval Hospital, San Diego 92134-5000
| | | | | | | |
Collapse
|
42
|
|
43
|
Abstract
Melanoacanthoma was originally described as a benign skin tumor of keratinocytes and dendritic melanocytes. There is now evidence that the intraoral lesions are unlike those occurring on skin. This article documents the reactive and reversible nature of the oral condition in a patient with these lesions.
Collapse
Affiliation(s)
- J M Wright
- Department of Pathology, Baylor College of Dentistry, Dallas, TX
| |
Collapse
|
44
|
Touyz LZ, Peters E. Candidal infection of the tongue with nonspecific inflammation of the palate. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1987; 63:304-8. [PMID: 3473358 DOI: 10.1016/0030-4220(87)90194-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A retrospective study of ten patients with median rhomboid glossitis (MRG) revealed the presence of a nonspecific inflammatory reaction of varying degrees of severity in the overlying palatal mucosa. Clinical records and photographs indicated that the palatal reactions physically approximated the underlying glossal lesions, suggesting a relationship between these entities. The nature of the relationship is uncertain, but it may involve a localized infection of the palatal mucosa by Candida species, from the MRG. Alternatively, irritation by soluble, possibly Candida-related factors from the MRG that are applied repeatedly to the palatal mucosa during swallowing may be responsible.
Collapse
|
45
|
Waxman M, Vuletin JC, Rosenblatt P, Herzberg FP. Melanocyte colonization of adenocarcinoma arising in an ovarian dermoid. Histopathology 1986; 10:207-15. [PMID: 3957253 DOI: 10.1111/j.1365-2559.1986.tb02475.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
An adenocarcinoma which arose in a dermoid cyst of the ovary displayed areas of melanocyte colonization and pigmentation. Ultrastructural study revealed the presence of epithelial tumour cells and melanocytes; many tumour cells contained compound melanosomes, but not premelanosomes, suggesting transfer of melanin from melanocytes to tumour cells. Melanocyte colonization of malignant tumours is a curious phenomenon the significance of which remains to be elucidated.
Collapse
|