What are the other Names for this Condition? (Also known as/Synonyms)

• Melanotic Macules of Mouth
• Melanotic Macules of Oral Cavity
• Oral Melanosis

What is Melanotic Macules of Oral Mucosa? (Definition/Background Information)

• Melanotic macules are dark spots that may be observed on the skin, mucus membranes of the mouth, genitalia, and in the nails. Melanotic macules are benign and no malignant transformation to a melanoma has been recorded
• A macule indicates the presence of a flat, distinct, discolored area of skin less than 1 cm wide. A macule usually does not involve any change in the thickness or texture of the affected skin
• Melanotic Macules of Oral Mucosa are observed on the lips, in the mouth, on the tongue, etc. It is a commonly observed skin condition that is seen in many children and adults
• 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. In such cases, the cause of the condition is genetically-influenced
• In most cases, Melanotic Macules of Oral Mucosa are asymptomatic and do not present any significant signs and symptoms. No complications are typically associated with these lesions; although in some cases, the macules may be confused for melanoma in situ (a precancerous skin condition)
• In a majority, no treatment of Melanotic Macules of Oral Mucosa may be necessary and the healthcare provider may undertake a ‘wait and watch’ approach
• In case treatment is necessary, it may be provided and the prognosis is excellent. However, the overall prognosis may depend upon the severity of the signs and symptoms of any underlying disorder (if any present)

Who gets Melanotic Macules of Oral Mucosa? (Age and Sex Distribution)

• About 3% of the population may have Melanotic Macules of Oral Mucosa
• It can be seen in both children and adults
• When it is seen on the lower lip, a female predominance is observed
• There is no racial or ethnic predilection for this skin condition

What are the Risk Factors for Melanotic Macules of Oral Mucosa? (Predisposing Factors)

Presently, there are no risk factors identified for solitary Melanotic Macule of Oral Cavity. In the case of multiple melanotic macules, the following rare genetic conditions may be involved:

• Laugier-Hunziker syndrome
• Carney complex
• LEOPARD syndrome
• Peutz-Jeghers syndrome
• LAMB syndrome
• NAME syndrome

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Melanotic Macules of Oral Mucosa? (Etiology)

The exact cause of Melanotic Macules of Oral Mucosa is not well-understood.

• When numerous macules are observed, they may be found in association with certain genetic conditions or syndromes
• When these macules occur in isolation, they are usually sporadic and no associated conditions are observed

The skin condition is not infectious and does not spread from one individual to another through contact.

What are the Signs and Symptoms of Melanotic Macules of Oral Mucosa?

The clinical signs and symptoms of Melanotic Macules of Oral Mucosa include the following:

• The presence of pigmented skin lesions/spots in the mouth and on the lips (lower lips usually)
• In the mouth, these lesions may be seen in the oral mucosa and tongue
• When macules are present on the lips, it is known as labial melanotic macules
• They form discolored flat and asymmetric patches less than 1 cm in size
• The color of the macules may be uniform or non-uniform; the color may vary from shades of dark brown to black
• The macules may be single or multiple; the borders are usually irregular
• When Laugier-Hunziker syndrome is present, the melanotic macules may involve the nail units too
• The underlying skin or mucosal surface usually remains unaffected; no change in the thickness or texture of the skin is typically observed
• The macules may be present unchanged for many years and some are indistinguishable from a melanoma (s skin cancer type)

How is Melanotic Macules of Oral Mucosa Diagnosed?

The diagnosis of Melanotic Macules of Oral Mucosa may involve the following procedures:

• The diagnosis is usually made by a complete physical (oral) examination and evaluation of medical history and family history
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination, who examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. A skin biopsy is performed to rule out other similar conditions

Note: A skin biopsy is not usually necessary, but may be performed if the healthcare provider suspects a malignancy such as a melanoma in situ.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Melanotic Macules of Oral Mucosa?

The complications of Melanotic Macules of Oral Mucosa may include the following:

• The longstanding skin patches can cause emotional stress and cosmetic concerns in some individuals
• The appearance of the pigmented macules may induce a fear of melanoma (which is a type of skin cancer)
• Complications that arise from an underlying genetic condition/syndrome

How is Melanotic Macules of Oral Mucosa Treated?

The treatment of Melanotic Macules of Oral Mucosa may include the following:

• The healthcare provider may choose to regularly observe the benign lesions; a “wait and watch” approach may be followed, once a diagnosis of a melanotic macule is established. In such cases, no treatment is generally required
• If required, a surgical excision and complete removal of the macule, primarily to address cosmetic issues may be undertaken
• Treatment of the underlying associated genetic disorder, if any
• Follow-up care with regular screening and check-ups are encouraged

How can Melanotic Macules of Oral Mucosa be Prevented?

There is currently no effective means of prevention of Melanotic Macules of Oral Mucosa, because the cause of this condition is unknown.

What is the Prognosis of Melanotic Macules of Oral Mucosa? (Outcomes/Resolutions)

• The prognosis of Melanotic Macules of Oral Mucosa is typically excellent with adequate treatment. No malignant transformations of these macules have been recorded
• In some cases, no treatment may be necessary and the healthcare provider may choose to observe these skin lesions (wait and watch approach)
• If these lesions are associated with any genetic disorders, then the overall prognosis depends upon the severity of the signs and symptoms of the disorder

Additional and Relevant Useful Information for Melanotic Macules of Oral Mucosa:

• Carney complex comprises a combination of medical conditions that includes multiple tumors, such as myxomas, schwannomas, endocrine disorders, and pigmented skin conditions

Please read more on Carney complex by visiting the following link below:

http://www.dovemed.com/diseases-conditions/carney-complex-cnc/