Labial melanotic macule — codes and concepts. HYPERPIGMENTED lesions involving the oral mucosa have various pathogenetic causes. A number of inherited diseases are manifested by pigmented oral lesions. The oral melanotic macule (MM) is a small, well-circumscribed brown-to-black macule that occurs on the lips and mucous membranes. If a skin biopsy is done because the lesion is changing or looks irregular, a labial melanotic macule shows the following features on dermatopathology: Nuclear atypia is absent and the melanocyte count is normal. If a child has one it is usually because of their race. Multiple lentiginosis (various syndromes including. The mucosal melanotic macule is a variant of simple lentigo that is located on mucosal surfaces, in particular the lower lip. If the melanotic macule is removed it can create a small scar or depression in the tissue which may or may not be noticeable. Sponsored content: melanomas are notoriously difficult to discover and diagnose. Once developed the lesions usually remain unchanged in size and colour. Melanotic macules are caused by functional hyperactivity of the regional melanocytes (ie, there is increased melanin production). The average age of presentation is 43 years, with a female predilection. Oral melanotic macule is a non-cancerous (benign), dark spot found on the lips or inside the mouth. Oral pigmentation is a relatively common condition that may involve any portion of the oral cavity. Melanin pigmentation tends to be present in significant amounts in the basal-cell layer and less often in the lamina propria. Occasionally the lesion can be on the upper lip. If you have any concerns with your skin or its treatment, see a dermatologist for advice. Clinically presentation of melanotic macules are typically a brown, black, blue or grey area that is well circumscribed, lesions are usually less than 10 mm in diameter but can be larger in some cases. This dark area could be a melanotic macule, which is a noncancerous dark patch on the skin — called hyperpigmentation — of a mucous membrane. Melanotic macules are benign pigmented lesions that are found in the oral cavity, caused by an increase in pigmentation in the basal cell layer of the epithelium and the lamina propria. In such cases, the cause of the condition is genetically-influenced 2003;139:767-770 YPERPIGMENTED lesions involving the oral mu-cosa have various patho-genetic causes. Conditions that are likely to cause macules are: vitiligo; moles; freckles Labial melanotic macules are differentiated from other entities by a combination of clinical and histologic features. The presence of numerous melanotic macules on the body may be associated with a variety of syndromes including Carney complex, Peutz-Jeghers syndrome, and LEOPARD syndrome. It has also been found on the genital areas. Some of the possible causes of Hypermelanotic macule or similar disorders may include: 2. Some possible causes of Hypermelanotic macule or similar disorders may include: 4 Acute febrile neutrophilic dermatosis (Hypermelanotic macule) Amish infantile epilepsy syndrome (Hypermelanotic macule) Angioma serpiginosum, X-linked (Hypermelanotic macule) 6 Biopsy for routine histopathologic examination is recommended to rule out oral melanoma in patients with melanotic macule on the palate, where malignant melanoma is most prevalent. We present evidence that this is a benign entity. Some of the rare genetic disorders associated with this condition include the following: 1. Being born with one or having it appear in early childhood, which is common for people who have dark skin. A dermatologist can evaluate a melanotic macule to determine if it poses any health risks to the patient. Intense pulsed light therapy which is a form of laser therapy. Melanin is a normal skin pigment that gives the skin its darker color. The labial melanotic macule: a review of 79 cases. Melanotic Macule Causes There is a variety of causes for a person to have a melanotic macule. Who's at risk? Typical lesions can just be observed. Histologically, this is evidenced by abundant melanin pigmentation within the basal epithelial cell layer with melanin incontinence in … An oral melanotic macule found on the lip is sometimes called a labial melanotic macule. Background: Genital melanotic macules are poorly recognized lesions, which appear as isolated discrete macules. 1,2 The oral melanotic macule presents in patients older than 40 years as a flat, blue, brown, or black, mostly solitary lesion less than 10 mm in diameter. [1] Oral pigmented lesions result from cellular hyperplasia that can range from benign nevi to fatal oral melanoma. However it may also occur in dark-skinned individuals and, as described above, similar lesions can arise in sites that are never sun-exposed. Excision but using this form of removal will leave you a scar. There are two major linked conditions. Luckily, melanotic macules are harmless. The color of the lesion is normally darker than the tissue that surrounds it. Last reviewed by Dr. Raj MD on August 14th, 2018. The exact cause for VM is unknown currently. Some of those causes can include: If the melanotic macule begins to change in texture, color, or shape it may be a cause for concern and should be check by either your physician or dermatologist. Home Their etiology is not clear and it may represent a physiologic or reactive process. Lesions can also be found in the mouth (oral melanotic macule), on the vulva (vulval labial melanotic macule; vulval melanosis) or on the penis (penile melanotic macule). There are two major related factors, including: 1. Suspicious lesions, including lesions showing progressive change, should be biopsied. We have followed up these patients for up to 13 years and 3 months (mean 6 years, 3 months). It occurs in approximately three percent of the population of the world. As most melanotic macule is benign for women they may be able to hide them under makeup if they are light in color and small enough so they do not attract any attention. Mucosal melanotic macule is a broader term encompassing lesions of the mouth as well as the lip. Multiple causes are known, and they may range from simple iatrogenic mechanisms, such as implantation of dental amalgam, to complex medical disorders, such as Peutz-Jeghers syndrome. Although most of the time they are solitary lesions there can be more than one. Luckily, melanotic macules are harmless. If it is irregular in shape or big it could be noticeable if removed. This lesion is completely benign, but biopsy must be performed to differentiate it from melanoma. Having a melanotic macule does not cause any symptoms but when you see one it is usually smaller than seven millimeters in diameter. A mucosal melanocytic macule is a well-defined, oval, brown to black, flat patch, usually found on the lip (a labial melanocytic macule). This medical condition is a dark spot that is usually found on your lips, usually the bottom one but can appear on the top lip also. As labial melanotic macules almost always occur on the central third of the lower lip, a site receiving maximum sun exposure, … They may be more common than the literature suggests, especially among dark-skinned subjects. Oral Melanotic Macule identifiable etiologic factor, the term oral melanotic macule has been suggested2. It is the name for a freckle arising on the lip. It is also sometimes called a labial lentigo and when multiple lesions are present, mucosal melanosis. A melanotic macule is normally benign, which means it is not cancerous. Although it can appear at any age in either sex, race, or gender, it is most commonly found in people who are dark skinned and in their middle ages and are female. What is the cause of labial melanotic macule? The etiology is not clear and it may represent a physiologic or reactive process. When these macules occur in isolation, they are usually sporadic and no associated conditions are observed. Congenital lingual melanotic macules represent a clinically distinct and benign cause of hyperpigmentation of the oral mucosa. If you have any concerns with your skin or its treatment, see a dermatologist for advice. Oral melanoacanthoma and oral melanotic macule: a report of 8 cases, review of the literature, and immunohistochemical analysis Román Carlos-Bregni 1 , Elisa Contreras 1 , Ana Carolina Netto , Adalberto Mosqueda-Taylor 2 , Pablo Agustin Vargas 3 , Jacks Clinical and dermatoscopic features of labial melanotic macule. Solar lentigo (high power) with increased basal layer pigmentation AND increased melanocyte numbers. The most common lesions are oral and labial melanotic macules. Usually solitary, a labial melanotic macule is most commonly seen in adult women but it also occurs in males and in young people. With your help, we can update and expand the website. A labial melanotic macule is thought to be provoked by sun exposure, and it is more common in fair-skinned people. Diagnosis confirmation. Objective: Our purpose was to define the clinical, histologic, immunohistochemical, and electronmicroscopic features of genital melanotic macules. A labial melanotic macule may be confused with another pigmented skin lesion. Shen ZY, Liu W, Bao ZX, Zhou ZT, Wang LZ Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011 Jul;112(1):e21-5. A labial melanotic macule is thought to be provoked by sun exposure, and it is more common in fair-skinned people. Note that this may not provide an exact translation in all languages, breadcrumbs A melanotic macule is a benign pigmented lesion of oral cavity characterised by increase in melanin pigmentation. » The exact cause of Melanotic Macules of Oral Mucosa is not well-understood. DermNet provides Google Translate, a free machine translation service. There are no outstanding histologic differences among the eighty specimens. Oral melanotic macule and primary oral malignant melanoma: epidemiology, location involved, and clinical implications. However it may also occur in dark-skinned individuals and, as described above, similar lesions can arise in sites that are never sun-exposed. Gupta G, Williams REA, Mackie RM. Oral melanotic macules can appear in people of any age, of any race, and of either sex. It is suggested that the term oral melanotic macule be used for these lesions, unless a specific cause can be confirmed by clinical data. It is usually asymptomatic and does not cause any severe signs or symptoms. Labial melanotic macule causes Labial melanotic macule is thought to be provoked by sun exposure, and it is more common in fair skinned people. If a person decides that they do want them removed this can be done by: Pictures collection of the condition Melanotic Macule…, 35 Most Frequently Asked Questions About Coronavirus (COVID-19) – (with references). doi: 10.1016/j.tripleo.2011.02.040. A labial melanotic macule is a well-defined, oval, brown to black, flat patch on the central third of the lower lip. Oral melanotic macule (MM) is a small, well-circumscribed, brown-to-black macule, and about of 665 cases has been reported in the English literature (2). Oral melanotic macules may have more of a predilection toward malignant melanoma than LMM. [Congenital melanotic macules of the tongue] A variation of the melanotic macule is the ephelis, or freckle, which generally appears as a small (2- to 3-mm) brown spot on the lip. H Arch Dermatol. Conclusion: The congenital lingual melanotic macule represents a clinically distinct, benign, pigmented oral melanoticlesion,andmaybemorecommonthanthelit-erature suggests. Brown macules on the lower lip are relatively common, especially in young adult women. See smartphone apps to check your skin. It can even be found on the inside of your mouth, gums, called gingiva, the roof your mouth on the soft or hard palate, or inner cheek called buccal mucosa. In the literature, the oral melanotic macule has been given various inappropriate and erroneous names, such as ephelis5,6 and lentigo7,8. Contact us to sponsor a DermNet newsletter. Figure 3. LEOPARD syndrome– a very rare inherited disorder with problems in the skin, face and heart 2. Lesions with a typical history and appearance need not be biopsied. Author: Dr Mark Duffill, Dermatologist, Hamilton, New Zealand, 2008. To make sure what type of treatment is needed, if any, they will usually do a skin biopsy to confirm if it is melanotic macule or another medical condition that could be precancerous or cancerous. Simple lentigo — Simple lentigines often appear during childhood as sharply circumscribed, round-to-oval, uniformly brown or … But before we proceed, we have to acknowledge that this condition is not related to systemic diseases or sunlight. The melanosis may occur on the vermilion border of the lip or the gingiva due to postinflammatory or posttraumatic causes. These are Genetic disorders and Lichen sclerosis. However, we know that it is due to over-production and accumulation of melanin within the tissues. Hence, treatment is not required. Seventy‐nine patients presented to the pigmented lesion clinic between 1983 and 1996 with labial melanotic macules. What causes an oral melanotic macule? DermNet NZ does not provide an online consultation service. Labial melanotic macule. These conditions can be differentiated from labial melanotic macule by a combination of clinical and histological features. Melanotic macules usually arise from three sources: an intraoral freckle, postinflammatory pigmentation, or disorders such as Addison’s disease, Peutz-Jeghers syndrome, or Laugier-Hunziker syndrome. Genetic disorders 2. In some people, if they opt to have it removed the tissue may heal well and leave little or no depression or scar. Oral melanotic macules do not cause an increase in the number of melanocytes and are not associated with a predisposition to melanoma. Similar freckles may also occur in areas that are not exposed to the sun: Labial melanotic macules do not cause any symptoms but their appearance can be a concern to the patient. GENETIC CAUSES. The lesions will usually appear as a flat non-itchy rash on the lip with a color that is uniform and has a border that is well-defined. They can occasionally have an irregular edge and there may be a history of colour change which can cause confusion with other pigmented lesions, including melanoma. It may also arise on the gingival, buccal, or palatal mucosa. Melanotic macule is a harmless benign condition. Lichen sclerosis – a skin disease which is characterized by white patches while are usually thinner than normal skin Some linked genetic disorders may include: 1. For most of the melanotic macule your dermatologist or physician will observe it over time to make sure that it does not change in shape, color, or texture and will not remove it and it will not need any treatment. A melanotic macule is a small dark spot that is usually benign, but may be a cause for concern if it changes in color, shape, or texture. DermNet NZ does not provide an online consultation service. [Sponsored content]. Macules can be caused by various conditions that affect the appearance of your skin, resulting in areas of discoloration. Some of those causes can include: Being born with one or having it appear in early childhood, which is common for people who have dark skin. Melanotic macule may be indicative of preexisting disorders such as Addison’s disease; Treatment of melanotic macule. Ephelis (freckle) is a circumscribed brown macule over skin that has been exposed to sunlight. If treatment is requested the macules can be frozen (cryotherapy) or removed using a laser or intense pulsed light. Local irritants, such as smoking, may also result in melanosis of varying degrees. These spots usually appear on the lips or genitals and can have a number of causes. British Journal of Dermatology 19997:136: 772-775. NAME syndrome– a … Like skin freckles, the exact cause of an oral melanotic macule is unknown. Labial melanotic macule (low power); mild acanthosis without elongation of rete ridges. Currently, there is no specific cause for this vulvar benign but there are some rarely linked factors. Topics A–Z Their occurrence, usually as new pigmented lesions in adult life, can cause concern because they can mimic early melanoma. Causes List for Hypermelanotic macule. » When numerous macules are observed, they may be found in association with certain genetic conditions or syndromes. 7,8 Another name for this medical condition is labial melanotic macule and it is sometimes referred to as a freckle on the lip. There is a variety of causes for a person to have a melanotic macule. Luckily, melanoma is very rare on the lip (but it can occur). According to RDH Magazine, this common oral condition is present in 3 percent of the general population and is caused by a … Peutz-Jeghers syndrome– a genetic disorder with benign hamartomatous polyps in the GI tract, lips and oral mucosa 3. 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