MULTIPLE ORAL MUCOSA PIGMENTATION: IMPORTANCE OF CLINICAL ASPECTS AND MEDICAL INVESTIGATION

Abstract

Solitary and multiple macules of the oral mucosa are associated with various causes. These lesions may represent different pathologic entities, thus requiring different treatments and follow-up. We present 2 clinical cases of patients with multiple pigmentations on oral mucosa. Case 1: A 31-year-old woman exhibited brown hyperpigmentation macules less than 5 mm in diameter affecting buccal mucosa and tongue borders. Homogeneous hyperpigmentation stripes on nails were also identified. Based on these characteristics and the absence of gastrointestinal signs and symptoms, the diagnosis of Laugier-Hunziker syndrome was established. Case 2: A 68-year-old woman showed multiple pigmented lesions on the tongue. Clinical hypotheses were Peutz-Jeghers syndrome and Laugier-Hunziker syndrome. Medical investigation revealed chronic abdominal pain history, gastrointestinal bleeding, and previous surgery for excision of polyps. In addition, multiple pigmented skin lesions were detected except on the nails, leading to the final diagnosis of Peutz-Jeghers Syndrome. Both patients remain under follow-up. Solitary and multiple macules of the oral mucosa are associated with various causes. These lesions may represent different pathologic entities, thus requiring different treatments and follow-up. We present 2 clinical cases of patients with multiple pigmentations on oral mucosa. Case 1: A 31-year-old woman exhibited brown hyperpigmentation macules less than 5 mm in diameter affecting buccal mucosa and tongue borders. Homogeneous hyperpigmentation stripes on nails were also identified. Based on these characteristics and the absence of gastrointestinal signs and symptoms, the diagnosis of Laugier-Hunziker syndrome was established. Case 2: A 68-year-old woman showed multiple pigmented lesions on the tongue. Clinical hypotheses were Peutz-Jeghers syndrome and Laugier-Hunziker syndrome. Medical investigation revealed chronic abdominal pain history, gastrointestinal bleeding, and previous surgery for excision of polyps. In addition, multiple pigmented skin lesions were detected except on the nails, leading to the final diagnosis of Peutz-Jeghers Syndrome. Both patients remain under follow-up.