The oral melanotic macule.

A clinical and histologic study of eighty oral melanotic lesions which do not readily fit into recognized categories of melanotic lesions was conducted. These lesions tend to occur in the fifth decade of life and are most frequently seen on the gingiva, with the buccal mucosa and palate the next most frequent sites. The lesions are usually single, smaller than 1 cm., but they may also occur as multiple lesions. There is no sex bias, and there seems to be a number of etiologic factors. In a few cases long-term follow-up was possible. There is no indication of a tendency toward recurrence or development of malignant lesions. Histologically, none of the lesions shows atypia. Melanin pigmentation tends to be present in significant amounts in the basal-cell layer and less often in the lamina propria. There are no outstanding histologic differences among the eighty specimens. It is suggested that the term oral melanotic macule be used for these lesions, unless a specific cause can be confirmed by clinical data. Although these lesions should not be considered premalignant, it would be prudent to remove them for histologic confirmation of clinical impressions.