Intraoral brown, bluish and black

conditions

:
07-3121101~2755
yukkwa@kmu.edu.tw


Understanding:
1. Differential diagnosis of intraoral brown,
bluish and black conditions


References:
1.
2.
3.
4.
5.

Kaohsiung Medical University, Oral Pathology Department

Cawson RA: Oral Diseases. 3rd Ed., pp. 11.2-11.10
Cawson RA: Oral Diseases. 3rd Ed., pp. 11.12
Cawson RA: Oral Diseases. 3rd Ed., pp. 11.13
AFIP (American air-force institute of pathology)

Melanin

Blood

Ref. 1

Brownish, Blackish
Pigmented Lesions
Exogenous

Endogenous

Localized

Endocrine

pigmented disorder
Hairy
tongue

Intraoral brown and black conditions

Tyrosine

DOPA

(dihydroxyphenylalanine)

Melanin

Tyrosinase

(Melanocyte Stimulating Hormone)

Ref. 2

Intraoral brown and black conditions

Normal

Lentigo simplex

Junctional activity

Compound nevus

Intramucosal nevus

Blue nevus

Ref. 2

Intraoral brown and black conditions

Lamina
propria
Intraoral
Junctional activity

Cutaneous

Intramucosal nevus
Compound nevus

Refs. 1, 2

Intraoral brown and black conditions

Melanophage

Oral Melanotic Macule

Epithelium

Pigmented
basal
cell

Pigmented
basal
keratinocyte

Refs. 1, 2

Intraoral brown and black conditions

Amalgam restoration

Amalgam retrograde filling

Amalgam Tatto

Refs. 1, 3

Intraoral brown and black conditions

Graphite Tatto

Ref. 1

Intraoral brown and black conditions

Hairy Tongue

Ref. 1

Early Changes of Melanoma

1. Appear recently
2. Change in degree of pigmentation
3. Bleeding or ulceration
4. Rapid growth (in size or elevated)

Refs. 1, 2

Melanoma

Ref. 1

Melanoma

Ref. 1

Melanoma

Ref. 1

Melanoma

Ref. 1

Melanoma

Immunohistochemical staining of HMB-45 (A) and S-100 (B) revealed diffuse

positivity in the tumor cells.

Ref. 1

Von Reclinghausens disease of skin

multiple neurofibroma
Cafa-Au-Lait-spot

Ref. 5

Cafa-Au-Lait-spot

Ref. 1

Addisons Disease
Pituitary

Gland
product

adrenorticotrophin hormone
( )

ACTH

Cause adrenal
production

Gluco-cortisoid (Hydrocortisone)
Into

Blood circulation
Ref. 4

Peutz-Jeghers Syndrome
Bluish black macules

Skin pigment (not oral) tends fade with age

Intestinal
polyp

Ref. 1

Hemangioma

Hematoma

Bluish Lesions

Mucocele

Eruption cyst

Ref. 1

Varicoses

Ref. 1

Mucoepidermoid Carcinoma

Ref. 1

SUMMARY
Knowing how to differentiate
brown, bluish & black
oral conditions