Abstract
Background: Oral melanoacanthoma is not common. It occurs mostly on the buccal mucosa. Since it happens suddenly and progresses rapidly, it clinically resembles melanoma. Melanoacanthoma occurs in regions susceptible to trauma. The clinical presentation of the lesion is not enough to diagnose it; therefore, tissue biopsy is necessary to exclude malignancy. Case report: We report a case of oral melanoacanthoma in a rare mucosal location in a 21-year old female patient. The generalized gingival melanoacanthoma was caused as a result of using teeth whitening strips. This irritating factor increased melanocyte activity in the gingival tissues and labial mucosa. Discussion: Oral melanoacanthoma is a rarely encountered pigmented lesion in the oral cavity and is especially uncommon in the gingiva. It is a reactive lesion affecting the mucous membranes with no risk of malignant transformation. This case report shows that teeth whitening strips may trigger oral melanoacanthoma in susceptible individuals. Long-term irritation of the oral tissues may increase the number of dendritic melanocytes throughout the epithelium and accordingly increase the brown pigmentation of the oral cavity. Eliminating all possible local sources of irritation and ruling out other causative factors are the standard first steps in the oral melanoacanthoma therapy. Conclusions: This case shows the importance of including oral melanoacanthoma in the differential diagnosis of diffuse gingival pigmented lesions.
Highlights
Oral Melanoacanthoma is a rare, pigmented lesion that usually occurs on the buccal mucosa
Generalized gingival melanoacanthoma is extremely rare, tissue biopsy is highly recommended to differentiate between melanoacanthoma and melanoma
We present a rare case of melanoacanthoma in the gingivae and the labial mucosae triggered by teeth whitening strips in a 21-year-old female patient
Summary
Oral Melanoacanthoma is a rare, pigmented lesion that usually occurs on the buccal mucosa. We present a rare case of melanoacanthoma in the gingivae and the labial mucosae triggered by teeth whitening strips in a 21-year-old female patient. Case report The patient of this case report was a 21-year-old female, Saudi Arabian college student She was referred by her dentist in July 2018 to an oral medicine specialist for evaluation of a three-month-history of remarkable intraoral, diffuse hyperpigmentation of the upper and lower gingivae and labial mucosae. The patient reported using teeth whitening strips for six weeks before the intraoral pigmentation happened Her past medical history revealed hypothyroidism for three years for which she had been taking 100 mcg/day of levothyroxine sodium. An intraoral examination showed asymptomatic, diffuse, smooth, macular blackish-brown pigmentation with irregular margins on both the upper and lower attached and free gingivae, and upper and lower labial mucosae (Figures 1a–1c). At 8-months follow up, the lesion had gradually faded (Figure 4)
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