Oral mucosal pigmentation



Many metal or non-metallic substances can cause oral lesions. The most common clinical manifestations of oral lesions are oral mucosal hyperpigmentation and stomatitis. Oral lesions manifest as pigmentation of different colors of the oral mucosa.



Ingestion caused by ingestion or long-term exposure to metals. In the past, metal salts such as barium, mercury and gold were widely used to treat certain diseases such as syphilis and rheumatoid arthritis. The therapeutic dose of the above metal preparation is close to the toxic dose, and there are many opportunities for side effects.


an examination

Related inspection

Oral X-ray examination of oral endoscope

1, tincture

Patients with long-term expectoration have a higher incidence of oral mucosal lesions. The most common clinical manifestations are oral mucosal pigmentation and stomatitis. According to some statistics, the incidence of pigmentation can reach 80%, and the incidence of stomatitis can reach more than 50%. It has been observed that after two injections of tincture, pigmentation can occur in the medial mucosa of the soft palate and buccal.

The pigmentation of the mucosa is generally blue-black, with gums being the most common, especially the gingival margin and interdental nipple. Pigmentation is also seen in the mucous membranes of the lips and buccal mucosa. Generally no symptoms. When the expectorant is excessive, ulcerative stomatitis and other systemic manifestations are often combined.

The systemic manifestations of acute sputum poisoning are bruising, dyspnea, and degenerative hemoglobinemia. Chronic poisoning can be manifested as gastrointestinal dysfunction, nausea, vomiting, diarrhea, flu-like symptoms, jaundice and kidney disease. Long bone X-ray examination shows a "twist line" in the epiphysis.

2, lead

The absorption of lead is generally slow, and the onset is often unconscious. Lead is rarely used as a medicinal product, and household appliances and occupational factors are the main causes of poisoning.

Symptoms caused by lead in the human body can be divided into symptoms of absorption and symptoms of poisoning. The most characteristic symptom of lead absorption is lead line, which is also the earliest symptom. The lead line is the same as the sputum line, with the gums as the main part, but the shape and distribution of the sputum line are slightly different. The lead line is gray pigmented under the naked eye. There are countless dark particles under the magnifying glass, and the sputum line is blue-black; the lead line is at a distance from the edge of the gum, and the sputum line is mainly the gingival margin and the interdental nipple.

Symptoms of lead poisoning include pale, nausea, vomiting, upper abdominal cramps, and difficulty breathing. Peripheral neuropathy can cause sagging of the wrist and sagging of the foot. The brain symptoms of lead are a serious manifestation.


Differential diagnosis

Melanoma (plakia) refers to melanin pigmentation spots that are not associated with melanin pigmentation in the oral mucosa caused by racial melanin, systemic diseases, or exogenous substances. The cause is unknown.

There are milky white spots on the oral mucosa or fused into a piece, which is quite like a milk block. The white film covers the mucous membrane of the mouth and is not easy to wipe off. At the beginning, it becomes a small piece, gradually merges into a large piece, which looks like milk. It is a clinical manifestation of neonatal thrush.