Oral Melanoacanthoma And Oral Melanotic Macule: A Report Of 8 Cases, Review Of The Literature, And Immunohistochemical Analysis

Abstract

Oral melanoacanthoma (MA) is a rare, benign pigmented lesion, similar to cutaneous MA, characterized by hyperplasia of spinous keratinocytes and dendritic melanocytes. The pathogenesis of oral MA remains uncertain, although its clinical behavior is suggestive of a reactive origin. The most common intraoral sites are the buccal mucosa, lip, palate and gingiva. The average age of presentation is 28 years, mainly in blacks, with a strong female predilection. The oral melanotic macule (MM) is a small, well-circumscribed brown-to-black macule that occurs on the lips and mucous membranes. The etiology is not clear and it may represent a physiologic or reactive process. The average age of presentation is 43 years, with a female predilection. A biopsy is recommended to distinguish these lesions from each other and from other oral melanocytic lesions. We depict four cases each of oral MA and MM, affecting Caucasian and Latin American mestizo patients. The clinicopathological features of these cases reflect its ample spectrum, and to the best of our knowledge, it is the first example of oral MA affecting a Caucasian boy reported in the English literature. Therefore oral MA and MM should be considered in the differential diagnosis of pigmented lesions in the oral mucosa in these populations. © Medicina Oral.125E374E379Mishima, Y., Pinkus, H., Benign mixed tumor of melanocytes and malpighian cells. Melanoacanthoma: Its relationship to Bloch's benign non-nevoid melanoepithelioma (1960) Arch Dermatol, 81, pp. 539-550Buchner, A., Merrell, P.W., Carpenter, W.M., Relative frequency of solitary melanocytic lesions of the oral mucosa (2004) J Oral Pathol Med, 33, pp. 550-557Wright, J.M., Binnie, W.H., Byrd, D.L., Dunsworth, A.R., Intraoral melanoacanthomas (1983) J Periodontol, 54, pp. 107-111Buchner, A., Merrell, P., Hanson, L., Leider, A., Melanocytic hyperplasia of the oral mucosa (1991) Oral Surg, Oral Med Oral Pathol, 71, pp. 58-62Wright, J.M., Intraoral melanoacanthoma: A reactive melanocytic hyperplasia. Case report (1988) J Periodontol, 59, pp. 53-55Tomich, C., Zunt, S.L., Melanoacanthosis (melanoacanthoma) of the oral mucosa (1990) J Dermatol Surg Oncol, 16, pp. 231-236Contreras, E., Carlos, R., Oral melanoacanthosis (melanoachantoma): Report of a case and review of the literature (2005) Med Oral Patol Oral Cir Bucal, 10 (1), pp. 11-12,9-11Fornatora, M.L., Reich, R.F., Haber, S., Solomon, F., Freedman, P.D., Oral melanoacanthomas: A report of 10 cases, review of the literature, and immunohistochemical analysis for HMB-45 reactivity (2003) Am J Dermatopathol, 25, pp. 12-15Matsuoka, L.Y., Glasser, S., Barsky, S., Melanoacanthoma of the lip (1979) Arch Dermatol, 115, pp. 1116-1117Goode, R.K., Crawford, B.E., Callihan, M.D., Neville, B.W., Oral melanoacanthoma. Review of the literature and report of ten cases (1983) Oral Surg Oral Med Oral Pathol, 56, pp. 622-628Scheneider, L.C., Mesa, M.L., Haber, S.M., Melanoacanthoma of the oral mucosa (1981) Oral Surg Oral Med Oral Pathol, 52, pp. 284-287Fatahzadeh, M., Sirois, D.A., Multiple intraoral melanoacanthomas: A case report with unusual findings (2002) Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 94, pp. 54-56Ho, K.K., Dervan, P., O'Loughlin, S., Powell, F.C., Labial melanotic macule: A clinical, histopathologic, and ultrastructural study (1993) J Am Acad of Dermatol, 28, pp. 33-39Sexton, F.M., Maize, J.C., Melanotic macules and melanoacanthomas of the lip. A comparative study with census of the basal melanocyte population (1987) Am J Dermatopathol, 9, pp. 438-444Horlick, H.P., Walther, R.R., Zegarelli, D.J., Silvers, D.N., Eliezri, Y.D., Mucosal melanotic macule, reactive type: A simulation of melanoma (1988) J Am Acad Dermatol, 19, pp. 786-791Buchner, A., Hansen, L.S., Pigmented nevi of the oral mucosa: A clinicopathologic study of 32 new cases and review of 75 cases from the literature: Part I. A clinicopathologic study of 32 new cases (1979) Oral Surg Oral Med Oral Pathol, 48, pp. 131-142Barker, B.F., Carpenter, W.M., Daniels, T.E., Kahn, M.A., Leider, A.S., Lozada-Nur, F., (1997) Oral mucosal melanomas: The WESTOP Banff workshop proceedings, 83, pp. 672-679. , Western Society of Teachers of Oral Pathology. Oral Surg Oral Med Oral Pathol Oral Radiol EndodBarrett, A.W., Raja, A.M., The immunohistochemical identification of human oral mucosal melanocytes (1997) Arch Oral Biol, 42, pp. 77-8