Registration for a live webinar on 'Neuroleptic malignant syndrome' is now open.
See webinar detailsWe noted you are experiencing viewing problems
-
Check with your IT department that JWPlatform, JWPlayer and Amazon AWS & CloudFront are not being blocked by your network. The relevant domains are *.jwplatform.com, *.jwpsrv.com, *.jwpcdn.com, jwpltx.com, jwpsrv.a.ssl.fastly.net, *.amazonaws.com and *.cloudfront.net. The relevant ports are 80 and 443.
-
Check the following talk links to see which ones work correctly:
Auto Mode
HTTP Progressive Download Send us your results from the above test links at access@hstalks.com and we will contact you with further advice on troubleshooting your viewing problems. -
No luck yet? More tips for troubleshooting viewing issues
-
Contact HST Support access@hstalks.com
-
Please review our troubleshooting guide for tips and advice on resolving your viewing problems.
-
For additional help, please don't hesitate to contact HST support access@hstalks.com
We hope you have enjoyed this limited-length demo
This is a limited length demo talk; you may
login or
review methods of
obtaining more access.
Printable Handouts
Navigable Slide Index
- Introduction
- Sources of brown or black pigmentation
- Extrinsic pigmentation
- Pigmentation caused by Chlorhexidine
- Examples of hairy tongues
- Hairy tongue biopsy
- Extrinsic pigmentation - management
- Clinical presentation of lesions - macules
- Clinical presentation of blebs, nodules or masses
- Amalgam tattoo
- Amalgam tattoo images
- Amalgam tattoo not located on restoration site
- Amalgam tattoo biopsy
- Higher view of amalgam tattoo biopsy
- Amalgam tattoo - management
- Other tattoos
- Graphite tattoo
- Graphite tattoo biopsy
- Ritual tattoo
- Medication-induced pigmentation
- Minocycline pigmentation
- Quinacrine pigmentation
- Imatinib pigmentation
- Imatinib pigmentation biopsy
- Heavy metal pigmentation
- Macular melanotic pigmentation
- Racial/physiologic pigmentation
- Racial pigmentation - tongue
- Melanotic macule
- Melanotic macule examples
- Melanotic macule - spectrum of changes
- Solitary melanotic macule
- Multiple oral melanotic macules
- Multiple melanotic macules example
- Multiple melanotic macules - biopsy
- Sudden multiple melanotic macules - example
- Addison disease
- Peutz-Jegher syndrome
- Post-inflammatory hypermelanosis
- Etiologies
- Lichen planus
- Diffused pigmentation after radiation - example
- Post-inflammatory hypermelanosis biopsy
- Melanoacanthosis
- Melanoacanthosis - example
- Melanoacanthosis biopsy
- Management
- Melanocytic nevi
- Blue nevus
- Nevi biopsy
- Melanocytic nevi are completely benign
- Melanoma in situ
- Melanoma in situ - example
- Extensive nature of melanoma in situ
- Macular vascular lesions
- Macular vascular lesions - examples
- Managing Petechiae and Ecchymoses
- Intrinsically pigmented lesions
- Varices/vascular malformations
- Varices examples
- Varix biopsy
- Sublingual varices and vascular malformations
- Biopsy: vascular malformation with thrombus
- Managing varices/vascular malformations
- Kaposi sarcoma
- Oral Kaposi sarcoma
- Kaposi sarcoma examples
- Kaposi sarcoma biopsy
- Nuclear positivity for Human Herpesvirus 8
- Managing oral Kaposi sarcoma
- Melanocytic nodules/masses
- Nodular melanocytic nevi
- Management of melanocytic nevi
- Oral melanoma
- Gingival melanoma - example
- Oral melanoma - partial maxillectomy example
- Proliferation of malignant melanocytes
- Oral melanoma management
- Acknowledgements
Topics Covered
- Extrinsic and intrinsic pigmentation
- Most common exogenous pigmented lesion: amalgam tattoo
- Most common endogenous pigmented lesion: melanotic macule
- Post-inflammatory hypermelanosis
- Multiple melanotic macules
- Biopsy should be performed when melanotic macules are larger than 1 cm, unevenly pigmented, nodular, or have irregular margins
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Woo, S. (2017, March 29). Pigmented, brown or black lesions [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved October 14, 2024, from https://doi.org/10.69645/BUVS1553.Export Citation (RIS)
Publication History
Financial Disclosures
- Dr. Sook-Bin Woo has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Transcript
Please wait while the transcript is being prepared...
0:00
My name is Dr. Sook-Bin Woo,
and I am Associate Professor
at the Harvard School
of Dental Medicine.
The topic for this lecture is Pigmented,
Brown or Black Lesions
of the Oral Cavity.
0:15
Pigmentations can occur
from either an exogenous sources,
which means outside the body,
or from an endogenous source,
which means inside the body.
The most common exogenous sources
of pigmentation are foods
that we eat every day,
so things like coffee and tea
that we drink
will often cause staining of the teeth.
Other very common exogenous pigments
that can cause lesions
in the oral cavity include amalgam,
graphite, medications that are taken,
ritual tattoos that occur
in some cultures in the world,
as well as imbibing heavy metals
for whatever reason.
Endogenous pigments
are those that are produced
by the cells within the body
and the two most common
are melanin pigment
produced by melanocytes,
which are often found on the skin
and also of coarse
within the oral epithelium
as well as blood-related pigments,
and these are related primarily
to the break down of red blood cells.
I just wanted to mention an interesting
chemical called homogentisic acid,
which is a phenolic acid
that is produced in the body
or accumulates in the body in patients
with alkaptonuria
which is poorly controlled,
and this causes very dark pigmentation
of many organs in the body.
But we're not going
to talk about that today.
It's just sort of an interesting
side note.
1:38
Let's start by talking a little bit
about extrinsic pigmentation
that refers to pigmentation
that lies on the surface
of the mucosa
or on the surfaces of teeth.
So these are exogenous
as well as extrinsic.
The most common are foods
that are pigmented,
so drinking lots of tea and coffee,
or smoking cigarettes,
chewing areca nut in all its forms,
and using chlorhexidine mouthwash
will often cause
a brownish black pigmentation
on the surfaces of the teeth.
The other very common sight
for extrinsic pigmentation
of exogenous origin
is the staining of the tongue,
and this gives rise
to a condition called a coated
or hairy tongue that is black or brown
usually because of pigment from foods,
whether this is a natural pigment
of the food
or whether the food has been dyed.
Pigmented tongue can also be caused
by bacterial products.
The tongue has many bacteria
on its surface
and the metabolites of these bacteria
are often sulfites,
and as we know,
most sulfites are black.
So very often the tongue
will have a black appearance
and that's called a black hairy tongue.
Patients who take
a lot of Pepto-Bismol
or bismuth subsalicylate for dyspepsia
will also often see
a black pigmentation on the tongue
because of the bismuth
which is a heavy metal.