Martyn David Ritchie

Oral melanoacanthoma is a rare acquired brown to black benign hyperpigmented lesion of the oral mucosa,most commonly on the buccal surface, which can suddenly arise and enlarge, possible as a reactive lesion following trauma. On a microscopic level, the lesions exhibit an increase in melanin in the basal layer along with an increase in dendritic melanocytes and eosinophils in the upper epithelium . The aim of this paper is to give a brief overview of oral melanoacanthoma, as it relates to the differential diagnosis of pigmented oral lesions and present a biopsy confirmed case of oral melanoacanthoma in a 63year old female with multiple melanotic lesions of the lip and several lesions of the hard palate.

A 63 year old female presented to general dental practice with multiple melanotic lesions of the external lip and several lesions of the hard palate. The patient reported that the lesions had appeared and increased rapidly in size before advice was sought from her General Medical Practitioner. She was then subsequently referred to secondary care, including Clinical Genetics with an onward referral to OMFS, for thorough investigation. Differential diagnoses considered had included malignant melanoma and Peutz-Jegher’s syndrome. This case is presented to highlight the possibility of oral melanoacanthoma when dealing with pigmented oral lesions, and to highlight the scarcity of caucasian patients as a demographic for this condition As of 2016, 115 cases have been reported in the literature prior to this one.

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