Abstract
A 43-year-old male patient sought treatment for a pigmented lesion on the upper lip that had been present for many years with no size changes and no history of trauma. The patient was healthy and was not taking any medication. Intraoral examination showed a lesion with asymmetric and irregular borders and non-homogeneous colors, measuring 11 mm in diameter. There were no other pigmented lesions on the oral mucosa or lower lip. Melanoma, melanoacanthoma, and melanotic macule were considered for differential diagnoses. Incisional biopsy was performed and histopathologic examination revealed a fragment of parakeratinized oral mucosa showing acanthosis and heavily pigmented basal layer. The lamina displayed a focal perivascular mild chronic inflammatory infiltration and melanophages. Scarce and discrete pigmented dendritic melanocytes were observed in the epithelium basal layer. Based on these histologic features, the diagnosis was oral melanotic macule. Twelve months post-treatment, the lesion remained unaltered, without changes in size or color.
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