How is melanin pigmentation differentiated from oral malignant melanoma?

Updated: Jan 31, 2020
  • Author: Elizabeth Ann Bilodeau, DMD, MD, MSEd; Chief Editor: Jeff Burgess, DDS, MSD  more...
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Melanin pigmentation is a common feature of the oral mucosa. This pigmentation is observed diffusely as racial pigmentation, which can be patchy, and focally as melanotic macules and nevi (see the image below). The relative constancy of the brown color, without variegation, indicates its benign status. However, melanoacanthoma, which is deeply brown-black, can arise suddenly and grow large. Although melanoacanthoma commonly occurs on the buccal mucosa of black women, it can appear on the palate (see the second image below). The lesion is often suggestive of melanoma; however, it represents a benign, possibly reactive process.

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