Pigmented Macula on the Gingival Papillain a Young Male: Diagnosis and Management: A Case Report

Case Report

Austin J Dent. 2017; 4(1): 1061.

Pigmented Macula on the Gingival Papillain a Young Male: Diagnosis and Management: A Case Report

Esteves C¹, Guimares L² and Migliari D¹*

1Department of Stomatology, School of Dentistry, University of Sao Paulo, Brazil

2Department of Stomatology, Section of Oral Pathology, School of Dentistry, University of Sao Paulo, Brazil

*Corresponding author: Dante Migliari, Universidade de So Paulo Faculdade de Odontologia, Departamento de Estomatologia, Disciplina de Estomatologia Clínica Av. Prof. Lineu Prestes, 2227, Cidade Universitária So Paulo, SP -Brazil

Received: December 08, 2016; Accepted: January 14, 2017; Published: January 17, 2017


A case of oral melanotic macula, on the gingival papilla, in a 13-yearold white male is presented. Underpinning this presentation is the diagnosis approach and management of a tiny, isolated pigmented spot, arising in an unusual site (gingival papilla) and affecting a young person. Even taking into account the overall benign appearance and clinical behavior of the lesion, the surgical excision was deemed the best intervention for the case, reassuring both the patient and parents. This approach is advisable since in most cases it is not possible to differentiate a benign-type oral pigmented lesion from a potentially precursor malignant type such as pigmented nevus exclusively on a clinical basis.

Keywords: Oral pigmented lesion; Melanotic macula; Diagnosis; Management


Physiologic melanin pigmentation is by far the most common darkened spot on the oral mucosa. They are easily and mainly recognizable by a diffuse pigmentation on the attached gingiva, predominantly seeing in dark-skinned individual orlight-skinned black individuals [1,2].

On the other hand, an isolated pigmented spot on the oral mucosa usually rings an alert signal. Although oral pigmented-related malignancy, represented by melanoma, is quite rare a lesion in the oral mucosa, the presence of an isolated pigmented lisianthus sitegets clinicians aware of a possible oral melanoma [3].

This article describes a case of a tiny, pigmented spot of the gingival papilla that, otherwise, was necessary to exclude malignancy.

Case Presentation

A 13-year-old white male was referred to our clinic for evaluation of small spot that had recently appeared on his gingiva. The patient’s parents were concerned about the nature of the lesion since the dentist that initially examined the patient had said that a biopsy would be necessary for a proper diagnosis. Clinically, there was a slightly raised, rounded shape lesion of brown color, with a smooth surface, measuring about 4 mm in diameter, on gingival papilla (Figure 1A). This was the only lesion seen in the oral mucosa; the patient had numerous philipson his skin-face. Apart from this, the patient was healthy.