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Zisis V, Papadopoulos P, Anagnostou E, Andreadis D, Poulopoulos A. Citalopram-Induced Oral Melanotic Macules in a Female Patient and a Review of the Literature. Cureus 2024; 16:e60889. [PMID: 38910786 PMCID: PMC11193105 DOI: 10.7759/cureus.60889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 06/25/2024] Open
Abstract
Pigmented lesions in the oral cavity can arise from the accumulation of external substances or internal pigments, resulting in black or brown discoloration. The etiology can be categorized as physiologic, reactive, neoplastic, idiopathic, or indicative of systemic illness. Several systemic drugs have been linked to the development of oral and/or cutaneous pigmentation, either by stimulating the production of melanin or by the accumulation of the drug or its byproducts. The medications most commonly associated with this condition include antimalarials, hormones, oral contraceptives, phenothiazines, chemotherapeutics, amiodarone, minocycline, zidovudine, clofazimine, and ketoconazole. The aim of this case report is to illustrate the drug-induced appearance of multiple melanotic macules in an 89-year-old female patient. The patient was referred to the Department of Oral Medicine and Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece, complaining of the recent and constant appearance of black spots in her oral cavity. Her medical history revealed a multitude of prescribed drugs, with citalopram being the most recently prescribed one, approximately one year prior to the examination. The clinical examination revealed multiple melanotic macules, on the upper and lower lip as well as on the hard and soft palate. Based on these findings, a biopsy of a melanotic macule of the lip was carried out. The histopathological examination showed that the basal layer of the stratified squamous epithelium exhibited hyperpigmentation (melanin-pigmented basal cells). In addition, scattered melaninophages were noted in lamina propria. Psychotropic drugs associated with cutaneous hyperpigmentation include citalopram. Therefore, our case constitutes an exception since citalopram induced intraoral and perioral, instead of cutaneous, hyperpigmentation.
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Affiliation(s)
- Vasileios Zisis
- Oral Medicine/Pathology, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Petros Papadopoulos
- Oral Medicine/Pathology, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | | | - Dimitrios Andreadis
- Oral Medicine/Pathology, Aristotle University of Thessaloniki, Thessaloniki, GRC
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2
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Iijima Y, Nakayama N, Yamada M, Hino S, Horie N, Kaneko T. Laugier-Hunziker Syndrome: A Rare Cause of Oral Mucosa Pigmentation. Gerontol Geriatr Med 2023; 9:23337214231191295. [PMID: 37565024 PMCID: PMC10411268 DOI: 10.1177/23337214231191295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/09/2023] [Accepted: 07/07/2023] [Indexed: 08/12/2023] Open
Abstract
Introduction: Various diseases cause pigmentation of the oral mucosa. Among them, however, Laugier-Hunziker syndrome is not well known to dentists. Laugier-Hunziker syndrome is a benign pigmentary disorder characterized by the unique expression of pigmentation of the mucosa, nails and skin. In this report, we present a rare case of Laugier-Hunziker syndrome that occurred in an elderly person. Case Presentation: The patient was an 84-year-old female resident of an elderly care facility. The institutional dental hygienist reported that she was concerned about the discoloration of the oral mucosa. On examination, she had pigmentation of her oral mucosa and nails. She had no history of any disease or medication that would cause pigmentation. Although this condition was initially unknown to us, a diagnosis of Laugier-Hunziker syndrome was made. Conclusion: We report a case of Laugier-Hunziker syndrome in an elderly woman, which is not a well-known condition among dental professionals. More knowledge about diseases that cause pigmentation of the oral mucosa would be helpful in dental practice, especially at external facilities.
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Affiliation(s)
- Yosuke Iijima
- Saitama Medical Center, Saitama Medical University, Japan
| | - Nami Nakayama
- Saitama Medical Center, Saitama Medical University, Japan
| | - Miki Yamada
- Saitama Medical Center, Saitama Medical University, Japan
| | - Shunsuke Hino
- Saitama Medical Center, Saitama Medical University, Japan
| | - Norio Horie
- Saitama Medical Center, Saitama Medical University, Japan
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3
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[Laugier-Hunziker syndrome : A rare differential diagnosis of mucocutaneous hyperpigmentation]. Hautarzt 2021; 73:298-302. [PMID: 34170334 PMCID: PMC8964554 DOI: 10.1007/s00105-021-04845-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2021] [Indexed: 11/27/2022]
Abstract
Laugier-Hunziker syndrome (LHS) is characterized by lentiginous hyperpigmentation of the oral mucosa and lips. In addition, longitudinal melanonychia and palmoplantar hyperpigmented lesions may occur. LHS is a clinical diagnosis of exclusion. Herein, we report the case of a 66-year-old woman with LHS. The clinical and histopathologic features of LHS are presented and important differential diagnoses are discussed.
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Ferreira LDS, Calderipe CB, Maass JB, Carrard VC, Martins MD, Abreu LG, Schuch LF, Uchoa Vasconcelos AC. Oral pigmented lesions in syndromic individuals: A systematic review. Oral Dis 2021; 28:531-540. [PMID: 33394507 DOI: 10.1111/odi.13769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/07/2020] [Accepted: 12/29/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To systematically integrate the available data published in the literature on oral pigmented lesions (OPL) associated with syndromes, summarizing the clinical and demographic features of the individuals. MATERIALS AND METHODS An electronic search was undertaken in six databases. Eligibility criteria were articles in English, Spanish, and Portuguese describing case reports or case series of OPL associated with syndromes. Data were aggregated and statistically evaluated. RESULTS About 108 articles reporting 149 cases of individuals with syndromes were identified. Among the affected individuals, nine syndromes were reported. The mean age at diagnosis was 35.93 years (0.41 to 83 years), with a predilection for white (n = 85/85.86%) female (n = 102/68.46%) individuals. As regards the number of lesions, 109 (73.15%) were multiple and 40 (26.85%) were single. Lip represented the anatomical location more affected (122 cases/38.01%), followed by the buccal mucosa (100 cases/31.15%). Brownish lesions accounted for 82 (69.49%) cases. The mean time of evolution was 10.52 years (0.16 to 56 years). OPL preceding diagnosis of the syndrome was observed in 111 (74.50%) cases. CONCLUSIONS Although these syndromes are uncommon, dentists should be able to recognize their manifestations, since oral manifestations can represent an important aspect in early diagnosis.
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Affiliation(s)
- Luíse Dos Santos Ferreira
- Diagnostic Center for Oral Diseases, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Camila Barcellos Calderipe
- Diagnostic Center for Oral Diseases, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Julianne Bartz Maass
- Diagnostic Center for Oral Diseases, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Vinicius Coelho Carrard
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Oral Diagnosis, Piracicaba Dental School, Universidade de Campinas, Piracicaba, Brazil
| | - Lucas Guimarães Abreu
- Department of Child's and Adolescent's Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lauren Frenzel Schuch
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade de Campinas, Piracicaba, Brazil
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Toedtling V, Crawford FC. Clinical and histopathological differential diagnosis of Laugier-Hunziker syndrome: An extremely rare case with unusual extensive oral hyperpigmentation. Clin Case Rep 2021; 9:309-313. [PMID: 33489178 PMCID: PMC7813034 DOI: 10.1002/ccr3.3522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 10/16/2020] [Accepted: 10/17/2020] [Indexed: 11/10/2022] Open
Abstract
Laugier-Hunziker syndrome is a rare and benign disorder characterized by hyperpigmentation of the lips and buccal mucosae with associated longitudinal melanonychia of nails. Clinical correlation is needed to rule out other pigmentary disorders.
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Affiliation(s)
- Verena Toedtling
- Division of DentistrySchool of Medical SciencesFaculty of Biology, Medicine and Health, Oral and Maxillofacial SurgeryThe University of ManchesterManchesterUK
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6
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Sputa‐Grzegrzolka P, Wozniak Z, Akutko K, Pytrus T, Baran W, Calik J, Glatzel‐Plucinska N, Domagala Z, Podhorska‐Okolow M, Stawarski A, Dziegiel P. Laugier‐Hunziker syndrome: a case report of the pediatric patient and review of the literature. Int J Dermatol 2020; 59:1513-1519. [DOI: 10.1111/ijd.15262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/12/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023]
Affiliation(s)
| | | | - Katarzyna Akutko
- 2nd Department and Clinic of Pediatrics, Gastroenterology and Nutrition Wroclaw Medical University Poland
| | - Tomasz Pytrus
- 2nd Department and Clinic of Pediatrics, Gastroenterology and Nutrition Wroclaw Medical University Poland
| | - Wojciech Baran
- Department of Dermatology, Venereology and Allergology Wroclaw Medical University Poland
| | - Jacek Calik
- Department of ChemotherapyLower Silesian Oncology Center Wroclaw Poland
| | - Natalia Glatzel‐Plucinska
- Division of Histology and Embryology Department of Human Morphology and Embryology Wroclaw Medical University Poland
| | - Zygmunt Domagala
- Division of Anatomy Department of Human Morphology and Embryology Wroclaw Medical University Poland
| | | | - Andrzej Stawarski
- 2nd Department and Clinic of Pediatrics, Gastroenterology and Nutrition Wroclaw Medical University Poland
| | - Piotr Dziegiel
- Division of Histology and Embryology Department of Human Morphology and Embryology Wroclaw Medical University Poland
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Abstract
Oral pigmented lesions have a wide range of clinical presentations, some of which correlate with cutaneous pigmented lesions. This article highlights these correlates and underscores important differences that can potentially have clinical impact. Moreover, given a nonspecific presentation of an oral pigmented lesion, the article provides a reference to aid clinicians with differential diagnoses based on clinical features. This article is an overview of pigmented lesions of the oral cavity, including localized reactive pigmented lesions, neoplastic pigmented lesions, and pigmented lesions as sequelae of a systemic disease.
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Affiliation(s)
- Eugene Ko
- Department of Oral Medicine, University of Pennsylvania, School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
| | - Neeraj Panchal
- Department of Oral Surgery, University of Pennsylvania, School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA
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8
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Guo J, Hu Y, Tu J, Yin ZQ. Black Maculae between the Toes: A Rare Form of Laugier-Hunziker Syndrome? Indian J Dermatol 2020; 65:69-70. [PMID: 32029947 PMCID: PMC6986122 DOI: 10.4103/ijd.ijd_18_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Jing Guo
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China. E-mail:
| | - YingYing Hu
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China. E-mail:
| | - Jie Tu
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China. E-mail:
| | - Zhi Qiang Yin
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China. E-mail:
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9
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Rosebush MS, Briody AN, Cordell KG. Black and Brown: Non-neoplastic Pigmentation of the Oral Mucosa. Head Neck Pathol 2019; 13:47-55. [PMID: 30671761 PMCID: PMC6405786 DOI: 10.1007/s12105-018-0980-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 10/24/2018] [Indexed: 01/14/2023]
Abstract
Black and brown pigmentation of the oral mucosa can occur due to a multitude of non-neoplastic causes. Endogenous or exogenous pigments may be responsible for oral discoloration which can range from innocuous to life-threatening in nature. Physiologic, reactive, and idiopathic melanin production seen in smoker's melanosis, drug-related discolorations, melanotic macule, melanoacanthoma and systemic diseases are presented. Exogenous sources of pigmentation such as amalgam tattoo and black hairy tongue are also discussed. Determining the significance of mucosal pigmented lesions may represent a diagnostic challenge for clinicians. Biopsy is indicated whenever the source of pigmentation cannot be definitively identified based on the clinical presentation.
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Affiliation(s)
- Molly S. Rosebush
- Louisiana State University, 1100 Florida Avenue, New Orleans, LA 70119 USA
| | | | - Kitrina G. Cordell
- Louisiana State University, 1100 Florida Avenue, New Orleans, LA 70119 USA
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10
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Duan N, Zhang YH, Wang WM, Wang X. Mystery behind labial and oral melanotic macules: Clinical, dermoscopic and pathological aspects of Laugier-Hunziker syndrome. World J Clin Cases 2018; 6:322-334. [PMID: 30283795 PMCID: PMC6163135 DOI: 10.12998/wjcc.v6.i10.322] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 06/28/2018] [Accepted: 07/24/2018] [Indexed: 02/05/2023] Open
Abstract
Labial and oral melanotic macules are commonly encountered in a broad range of conditions ranging from physiologic pigmentation to a sign of an underlying life-threatening disease. Although Laugier-Hunziker syndrome (LHS) shares some features of labial and oral pigmentation with a variety of conditions, it is a benign and acquired condition, frequently associated with longitudinal melanonychia. Herein, the demographic, clinical, dermoscopic, and pathological aspects of LHS were reviewed comprehensively. The important differential diagnoses of mucocutaneous and nail pigmentation are provided. An accurate diagnosis is crucial to design a reasonable medical strategy, including management options, malignant transformation surveillance, and psychological support. It is important that clinicians conduct long-term follow-up and surveillance due to the potential risks of malignant transformation and local severe complications in some conditions.
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Affiliation(s)
- Ning Duan
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Yang-Heng Zhang
- Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Wen-Mei Wang
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Xiang Wang
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China
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11
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Miličević T, Žaja I, Tešanović D, Radman M. Laugier-Hunziker syndrome in endocrine clinical practice. Endocrinol Diabetes Metab Case Rep 2018; 2018:EDM180025. [PMID: 30087778 PMCID: PMC6063988 DOI: 10.1530/edm-18-0025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 04/13/2018] [Indexed: 11/21/2022] Open
Abstract
Laugier–Hunziker syndrome (LHS) is a rare, benign and acquired disorder characterized by hyperpigmentation of the oral cavity and lips along with longitudinal melanonychia. No underlying systemic abnormalities or malignant predisposition is associated with it. In everyday clinical practice, an endocrinologist encounters certain endocrine conditions (e.g. Addison’s disease, McCune–Albright syndrome) that present with, inter alia, mucocutaneous hyperpigmentation. Even though LHS is easily distinguished from endocrine entities mentioned earlier, diagnostic evaluation usually requires skilled and thorough practitioner. Since it is the diagnosis of exclusion, a number of systemic conditions must be ruled out prior to making the final diagnosis. However, its major differential diagnosis is primarily Peutz-Jeghers syndrome, which carries an increased risk of cancer. Here, we report a case of a young woman who was referred to the endocrinologist for diagnostic evaluation of dark-colored lesions of the oral cavity and nails. All performed laboratory tests were within reference range. Endoscopic gastrointestinal evaluation did not reveal neoplastic formations. Owing to an adult-onset, asymptomatic clinical course and negative diagnostic findings, we made a final diagnosis. In this case, target diagnostic evaluation notably reduced the need for additional expensive and invasive procedures and treatments.
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Affiliation(s)
- Tanja Miličević
- Departments of Endocrinology, Diabetes and Metabolic Diseases
| | - Ivan Žaja
- Departments of Gastroenterology and Hepatology, University Hospital Center Split, University of Split Medical School, Split, Croatia
| | - Deša Tešanović
- Departments of University of Split Medical School, Split, Croatia
| | - Maja Radman
- Departments of Endocrinology, Diabetes and Metabolic Diseases
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Zaki H, Sabharwal A, Kramer J, Aguirre A. Laugier-Hunziker Syndrome Presenting with Metachronous Melanoacanthomas. Head Neck Pathol 2018; 13:257-263. [PMID: 29450847 PMCID: PMC6514033 DOI: 10.1007/s12105-018-0897-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 02/12/2018] [Indexed: 12/15/2022]
Abstract
Laugier-Hunziker syndrome (LHS, also termed idiopathic lenticular mucocutaneous hyperpigmentation) is an unusual condition characterized by progressive pigmentation of the mucous membranes. LHS displays a benign course and is not associated with malignancy. Here we present a case of LHS with a 7-year follow-up. We document metachronous oral melanoacanthomas in this individual. In addition, we found that the oral melanotic macules in this patient waxed and waned in a cyclical manner. To our knowledge, this is the first report of these findings in the context of LHS. Finally, we provide an overview of other conditions that can present with mucosal hyperpigmentation. It is critical to distinguish LHS from other conditions characterized by mucosal pigmentation in order to facilitate optimal patient care.
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Affiliation(s)
- Hattan Zaki
- Oral Basic and Clinical Sciences Department, Faculty of Dentistry, Taibah University, Madinah, Saudi Arabia
| | - Amarpreet Sabharwal
- Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY USA
| | - Jill Kramer
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY USA
| | - Alfredo Aguirre
- Department of Oral Diagnostic Sciences, School of Dental Medicine, University at Buffalo, The State University of New York, 355 Squire Hall, 3435 Main Street, Buffalo, NY 14214-3008 USA
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13
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Wei Z, Li GY, Ruan HH, Zhang L, Wang WM, Wang X. Laugier-Hunziker syndrome: A case report. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 119:158-160. [PMID: 29246753 DOI: 10.1016/j.jormas.2017.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 11/05/2017] [Accepted: 12/06/2017] [Indexed: 01/20/2023]
Abstract
Laugier-Hunziker syndrome (LHS) is a rare, benign, acquired pigmentary condition mainly affecting lips, oral mucosa and acral area, frequently associated with longitudinal melanonychia. Herein, we reported a 45-year-old female case with LHS. The clinical, dermoscopic, histopathologic features of LHS were reviewed and the important differential diagnosis was discussed.
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Affiliation(s)
- Z Wei
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, 210008 Nanjing, China
| | - G-Y Li
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, 210008 Nanjing, China
| | - H-H Ruan
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, 210008 Nanjing, China
| | - L Zhang
- Department of Oral Pathology, Nanjing Stomatological Hospital, Medical School of Nanjing University, 210008 Nanjing, China
| | - W-M Wang
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, 210008 Nanjing, China.
| | - X Wang
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, 210008 Nanjing, China.
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14
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Bhoyrul B, Paulus J. Macular pigmentation complicating irritant contact dermatitis and viral warts in Laugier-Hunziker syndrome. Clin Exp Dermatol 2015; 41:294-6. [PMID: 26508289 DOI: 10.1111/ced.12764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2015] [Indexed: 01/01/2023]
Abstract
Laugier-Hunziker syndrome (LHS) is a rare acquired disorder characterized by macu-lar pigmentation of the lips and oral mucosa, with frequent longitudinal melanonychia. Involvement of other areas, such as the genitalia and fingers, has rarely been described. LHS is a benign condition with no known systemic manifestations. We report the case of a woman who developed melanotic macules on her fingers and elbow 16 years after the onset of pigmentation of her lips. This unusual feature of LHS in our patient was associated with irritant contact dermatitis and viral warts. Only two cases of an association with an inflammatory dermatosis have been reported previously in the literature.
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Affiliation(s)
- B Bhoyrul
- Department of Dermatology, Singleton Hospital, Swansea, UK
| | - J Paulus
- Department of Dermatology, Singleton Hospital, Swansea, UK
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15
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Ge Y, Jia G, Lin T. Gütegeschaltete Nd:YAG-Laserbehandlung labialer Lentigines bei Peutz-Jeghers-Syndrom. J Dtsch Dermatol Ges 2015. [DOI: 10.1111/ddg.12627_suppl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Yiping Ge
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences; China
| | - Gaorong Jia
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences; China
| | - Tong Lin
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences; China
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16
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Ge Y, Jia G, Lin T. Q-switched Nd:YAG laser treatment for labial lentigines associated with Peutz-Jeghers syndrome. J Dtsch Dermatol Ges 2015; 13:551-5. [PMID: 26018367 DOI: 10.1111/ddg.12627] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2014] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND OBJECTIVE Labial lentigines associated with Peutz-Jeghers syndrome are cosmetically disfiguring and distressful. Although multiple treatment modalities including Q-switched ruby laser and Q-switched alexandrite laser have been proposed, experience with Q-switched Nd:YAG laser has been lacking. This study aimed to retrospectively evaluate the efficacy and safety of Q-switched Nd:YAG laser (532 nm) for labial lentigines in Peutz-Jeghers syndrome. PATIENTS AND METHODS Demographic and clinical data of 11 patients diagnosed with Peutz-Jeghers syndrome were analyzed. A quartile grading system was used. All patients were treated with a Q-switched Nd:YAG laser system with the following parameters: wavelength 532 nm; spot size 3 mm; pulse duration 5-20 ns; fluence 1.8-2.2 J/cm(2) . RESULTS After two to six (mean 3.6) treatment sessions, an average grade of 3.73 was achieved. Eight patients (72.7 %) showed an excellent response with more than 75 % lesion clearance. Three patients (27.3 %) showed a good response. Repeated treatments led to improved clearance of labial lentigines. Age, gender, and Fitzpatrick skin type were not statistically associated with efficacy grades after the first treatment session. Neither recurrence in treated areas nor significant complications were observed. CONCLUSIONS Q-switched Nd:YAG laser provides an effective and safe treatment option for labial lentigines associated with Peutz-Jeghers syndrome.
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Affiliation(s)
- Yiping Ge
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences, China
| | - Gaorong Jia
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences, China
| | - Tong Lin
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences, China
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Abstract
Oral pigmentation may be focal, multifocal, or diffuse. The lesions may be blue, purple, brown, gray, or black. They may be macular or tumefactive. Some are localized harmless accumulations of melanin, hemosiderin, or exogenous metal; others are harbingers of systemic or genetic disease; and some can be associated with life-threatening medical conditions that require immediate intervention. The differential diagnosis for any pigmented lesion is extensive, and can include examples of endogenous and exogenous pigmentation. Although biopsy is a helpful and necessary aid in the diagnosis of focally pigmented lesions, with diffuse presentations lesions require a thorough history and laboratory studies to establish a definitive diagnosis.
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Affiliation(s)
- Faizan Alawi
- Department of Pathology, School of Dental Medicine, University of Pennsylvania, 240 South 40th Street, Room 328B, Philadelphia, PA 19104-6002, USA.
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18
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Nikitakis NG, Koumaki D. Laugier-Hunziker syndrome: case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:e52-8. [PMID: 23562360 DOI: 10.1016/j.oooo.2012.12.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 12/14/2012] [Accepted: 12/21/2012] [Indexed: 12/22/2022]
Abstract
Laugier-Hunziker syndrome is a rare acquired disorder characterized by diffuse pigmented macules of the oral mucosa. Other mucosal and cutaneous surfaces may be affected, and nail involvement is frequent. A case of Laugier-Hunziker syndrome in a Greek female with multiple buccal and labial mucosal lesions and unusual conjunctival involvement is presented here. In addition, a thorough review of the English language literature of this rather under-recognized syndrome is included and the main differential diagnostic possibilities are discussed.
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Affiliation(s)
- Nikolaos G Nikitakis
- Department of Oral Pathology and Medicine, Dental School, National and Kapodistrian University of Athens, Athens, Greece.
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Abstract
Hyperpigmentation of the lips is a common condition. It is associated with a wide variety of conditions that include physiologic changes, genodermatoses, inflammatory diseases, endocrinologic disorders, drugs and chemicals, benign and malignant neoplasm, and other non-melanotic conditions. The aim of this article is to provide a clinical approach to hyperpigmented lesions on the lips based on the extent of lesions, the age of onset, and associated systemic involvements. In this review, we present an algorithm to guide the diagnosis of and plan for therapeutic intervention for pigmented lesions of the lips. The algorithm is based on the typical clinical presentation of each entity and should not be taken as an absolute indicator of diagnosis. Although the differences in color can help to differentiate among pigmented lesions, the interpretation of color can be subjective and is influenced by the amount and location of the pigment within the mucosa. The limitations of this review are that some data are based on case reports and small case series that may not reflect true association.
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Affiliation(s)
- Vasanop Vachiramon
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Abstract
Laugier–Hunziker syndrome (LHS) is an acquired pigmentary condition affecting lips, oral mucosa and acral area, frequently associated with longitudinal melanonychia. There is neither malignant predisposition nor underlying systemic abnormality associated with LHS. Herein, we present three uncommon cases of LHS with possibly new feature of nail pigmentation, which were diagnosed during the past 2 years. We also review the clinical and histological findings, differential diagnosis, and treatment of the syndrome in published literature.
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Abstract
Laugier-Hunziker syndrome is a rare acquired disorder characterized by diffuse hyperpigmentation of the oral mucosa and longitudinal melanonychia in adults. They appear as macular lesions less than 5 mm in diameter. Laugier-Hunziker syndrome is considered to be a benign disease with no systemic manifestation or malignant potential. Therefore, it is important to rule out other mucocutaneous pigmentary disorders that do require medical management. Prompt clinical recognition also averts the need for excessive and invasive procedures and treatments. In India, the reported cases of this syndrome are very few. We provide a review of literature on Laugier-Hunziker syndrome with its differential diagnosis.
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Affiliation(s)
- Ramakant S Nayak
- Department of Oral Pathology and Microbiology, Maratha Mandal's NG Halgekar Institute of Dental Sciences and Research Centre, Belgaum, Karnataka, India
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Woo SB. Diseases of the oral mucosa. MCKEE'S PATHOLOGY OF THE SKIN 2012:362-436. [DOI: 10.1016/b978-1-4160-5649-2.00011-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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23
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Woo SB. Pigmented Lesions. ORAL PATHOLOGY 2012:185-209. [DOI: 10.1016/b978-1-4377-2226-0.00009-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Laugier-hunziker syndrome: an uncommon cause of oral pigmentation and a review of the literature. Int J Dent 2010; 2010:525404. [PMID: 20671949 PMCID: PMC2910470 DOI: 10.1155/2010/525404] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Accepted: 05/24/2010] [Indexed: 12/25/2022] Open
Abstract
Laugier-Hunziker syndrome is a rare benign condition characterized by diffuse oral hyperpigmentation associated with pigmentation of the nails. The syndrome must be included in the differential diagnosis of diffuse oral pigmentation to exclude other conditions with systemic implications. We describe a 43-year-old white woman with the clinical and histological features of Laugier-Hunziker syndrome associated with toenail pigmentation. The correct clinical identification avoids the need for detailed investigations and treatment. We also review the potential causes of oral pigmentation.
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Ozden MG, Onder M, Gurer MA. Familial longitudinal melanonychia and premature hair greying: a new genetic entity? J Eur Acad Dermatol Venereol 2009; 23:1096-8. [DOI: 10.1111/j.1468-3083.2009.03092.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Vasovcák P, Puchmajerová A, Roubalík J, Krepelová A. Mutations in STK11 gene in Czech Peutz-Jeghers patients. BMC MEDICAL GENETICS 2009; 10:69. [PMID: 19615099 PMCID: PMC2726128 DOI: 10.1186/1471-2350-10-69] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Accepted: 07/19/2009] [Indexed: 12/04/2022]
Abstract
Background Peutz-Jeghers syndrome (PJS) is an autosomal dominant hereditary disease characterized by mucocutaneous pigmentation and gastrointestinal hamartomatous polyposis. The germline mutations in the serine/threonine kinase 11 (STK11) gene have been shown to be associated with the disease. Individuals with PJS are at increased risk for development of various neoplasms. The aim of the present study was to characterize the genotype and phenotype of Czech patients with PJS. Methods We examined genomic DNA of 8 individuals from five Czech families by sequencing analysis of STK11 gene, covering its promotor region, the entire coding region and the splice-site boundaries, and by multiplex ligation-dependent probe amplification (MLPA) assay designed for the identification of large exonic deletions or duplications of STK11 gene. Results We found pathogenic mutations in STK11 gene in two families fulfilling the diagnostic criteria of PJS and in one of three sporadic cases not complying with the criteria. The patient with the frameshift mutation in STK11 gene developed aggressive gastric cancer. No other studied proband has developed a carcinoma so far. Conclusion Our results showed that a germline mutation of STK11 gene can be found not only in probands fulfilling the PJS diagnostic criteria, but also in some sporadic cases not complying with the criteria. Moreover, we observed a new case of aggressive gastric cancer in a young patient with a frameshift mutation of STK11 gene.
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Affiliation(s)
- Peter Vasovcák
- Department of Biology and Medical Genetics, Charles University 2nd Medical School, University Hospital Motol, Prague, Czech Republic.
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Aliagaoglu C, Yanik ME, Albayrak H, Güvenç SC, Yildirim U. Laugier-Hunziker syndrome: diffuse large hyperpigmentation on atypical localization. J Dermatol 2009; 35:806-7. [PMID: 19239567 DOI: 10.1111/j.1346-8138.2008.00577.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Abstract
Volar melanotic macules are asymptomatic, tan-brown to brownish-black macules found on the palms, fingers, soles, and/or toes of dark-skinned individuals and are infrequently reported in light-skinned individuals. Herein, we report the acquisition of multiple, brownish-black volar digital macules in a 63-year-old white woman and avid gardener that were noted after the onset of pruritic, chronic hand dermatitis over a 10-month period. She was healthy without any medical conditions or medications. No family history of intestinal polyposis or mucosal melanosis existed. At presentation, she had less than 20 brownish-black, 2- to 10-mm irregular macules over the volar aspect of the thumbs and index fingers, left greater than right hand, associated with erythema, scale, and a negative potassium hydroxide examination. In addition, she had melanotic macules of her lips, buccal mucosa, and conjuctiva. No nail or anogenital macules were found. Biopsy demonstrated a region of epidermal hyperplasia, hyperkeratosis, and interface dermatitis associated with melanophages and sparse lymphocytic infiltrate. Melanin staining revealed diffuse pan-epidermal hypermelanization, dermal melanin, and dendritic melanocytes, which expressed HMB-45. After 1-year follow-up and treatment with topical corticosteroid, the volar macules have faded to tan brown. Based on the location, avocation, and coexisting mucosal melanotic macules, an irritant phytodermatitis with postinflammatory hyperpigmentation was diagnosed in the setting of Laugier-Hunziker syndrome-a disorder denoted by macular hyperpigmentation of nail, volar, and/or mucosal surfaces in healthy adults. Volar melanotic macules can also complicate 5-flourouracil therapy, tinea pedis, and other inflammatory disorders; be associated with acral melanomas; or represent a cutaneous manifestation of systemic disease such as Addison disease, Peutz-Jegher syndrome, Leopard syndrome, Carney syndrome, AIDS, and neurofibromatosis.
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Kim EJ, Cho SH, Lee JD. A Case of Laugier-Hunziker Syndrome. Ann Dermatol 2008; 20:126-9. [PMID: 27303175 PMCID: PMC4903962 DOI: 10.5021/ad.2008.20.3.126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2008] [Accepted: 03/04/2008] [Indexed: 12/14/2022] Open
Abstract
Laugier-Hunziker syndrome is a rare idiopathic acquired hyperpigmentation of oral mucosa and lips which is often associated with longitudinal melanonychia. This condition is known to be an entirely benign disease with no systemic manifestations. Herein we report a case of a 54-year-old woman presenting with a 7-year history of asymptomatic oral pigmentation and linear pigmented streaks of several fingernails. Histological examination taken from the mucosal lesion of tongue revealed increased pigmentation at the epithelial basal layer and a few melanophages in the submucosa. The lack of a family history coupled with the absence of any polyps on the endoscopic examinations of upper and lower bowel as well as the clinical features with late onset were all in favor of a diagnosis of Laugier-Hunziker syndrome. The significance of this disease is due to the need to differentiate this disorder from other pigmentary disorders of the oral mucosa, especially Peutz-Jeghers syndrome.
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Affiliation(s)
- Eun Jung Kim
- Department of Dermatology, Our Lady of Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Sang Hyun Cho
- Department of Dermatology, Our Lady of Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Jeong Deuk Lee
- Department of Dermatology, Our Lady of Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
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Meleti M, Vescovi P, Mooi WJ, van der Waal I. Pigmented lesions of the oral mucosa and perioral tissues: a flow-chart for the diagnosis and some recommendations for the management. ACTA ACUST UNITED AC 2008; 105:606-16. [PMID: 18206403 DOI: 10.1016/j.tripleo.2007.07.047] [Citation(s) in RCA: 123] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Revised: 05/13/2007] [Accepted: 07/30/2007] [Indexed: 12/15/2022]
Abstract
The term "pigmentation of the oral mucosa" is applied to a wide range of lesions or conditions featuring a change of color of oral tissues. Lesions not associated with an accumulation of pigment (e.g., Fordyce spots) are usually not classified as pigmented lesions. Two groups of pigmented lesions of the oral mucosa are recognized: 1) melanin-associated lesions, including racial pigmentations, melanotic macules, melanocytic nevi, and malignant melanoma; and 2) nonmelanin-associated lesions (e.g., blood-related pigmentations, metallic pigmentations). This paper presents a clinicopathologic review of the recent literature with emphasis on the main diagnostic features, including the use of immunohistochemical markers. A flow-chart is added that may help the clinician in the diagnosis and management of these lesions.
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Affiliation(s)
- Marco Meleti
- Unit of Oral Pathology and Medicine, Section of Odontostomatology, Department of ENT, Dental, Ophthalmological, and Cervicofacial Sciences, University of Parma, Parma, Italy
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Sabesan T, Ramchandani PL, Peters WJN. Laugier-Hunziker syndrome: a rare cause of mucocutaneous pigmentation. Br J Oral Maxillofac Surg 2005; 44:320-1. [PMID: 15964106 DOI: 10.1016/j.bjoms.2005.04.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2004] [Accepted: 04/21/2005] [Indexed: 12/15/2022]
Abstract
An 80-year-old white woman presented with brown pigmentation on both sides of the buccal mucosa and lower lip and patchy freckling in her nails, which was diagnosed as Laugier-Hunziker syndrome.
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Affiliation(s)
- T Sabesan
- Department of Oral and Maxillofacial Surgery, Poole General Hospital, Longfleet Road, Poole, Dorset BH15 2JB, UK
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Moore RT, Chae KAM, Rhodes AR. Laugier and Hunziker pigmentation: a lentiginous proliferation of melanocytes. J Am Acad Dermatol 2004; 50:S70-4. [PMID: 15097932 DOI: 10.1016/j.jaad.2003.09.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Macular pigmentation of Laugier and Hunziker is an acquired disorder involving lips, oral mucosa, acral surfaces, nail apparatus, or a combination of these in the absence of systemic disease, and is reported to show intraepidermal melanosis without melanocytosis. We present a 69-year-old white man with typical features of this disorder, involving lips and oral mucosa, first appearing 4 years before presentation. A pigmented macule on sun-exposed lip vermilion revealed increased numbers of slightly atypical melanocytes in a lentiginous epidermal pattern. A buccal mucosa pigmented macule and adjacent nonpigmented mucosa were studied using hematoxylin and eosin staining, and S-100 and L-3,4 dihydroxyphenylalanine histochemistry. The buccal mucosa macule revealed markedly increased numbers of dendritic, L-3,4 dihydroxyphenylalanine-reactive intraepithelial melanocytes. Further studies are warranted to determine if this pigmentation disorder represents a spectrum of histopathologic change or, in fact, should be renamed mucocutaneous lentiginosis of Laugier and Hunziker.
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Affiliation(s)
- Roger T Moore
- Department of Dermatology, Rush Medical College, Rush-Presbyterian-St Luke's Medical Center, 1653 W Congress Parkway, 507 Kidston, Chicago, IL 60612, USA
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Siponen M, Salo T. Idiopathic lenticular mucocutaneous pigmentation (Laugier-Hunziker syndrome): a report of a case. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2003; 96:288-92. [PMID: 12973285 DOI: 10.1016/s1079-2104(03)00295-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Laugier-Hunziker syndrome (LHS) is an acquired, benign, macular hyperpigmentation of the lips and oral mucosa, often associated with pigmentation of the nails. It is a rare disorder thought to be more common than the number of reported cases would suggest. It is important to include this condition in the differential diagnosis of diffuse oral pigmentation. Here we report the first case of the Laugier-Hunziker syndrome in Scandinavia. Other conditions causing diffuse or multifocal pigmented oral lesions are discussed.
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Affiliation(s)
- Maria Siponen
- Univeristy of Oulu, Oulu University Hospital, Oulu, Finland.
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Abstract
We report the unusual occurrence of 3 cases of Laugier-Hunziker syndrome in the same family.
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Affiliation(s)
- Edouard N Makhoul
- Department of Dermatology, Hôtel-Dieu de France, Achrafieh, PO Box 16-1830, Beirut, Lebanon
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Vega Gutiérrez J, Miranda Romero A, Martínez G, Torrero MV, López de Juan M. Hyperpigmentation mimicking Laugier syndrome, levodopa therapy and Addison's disease. J Eur Acad Dermatol Venereol 2003; 17:324-7. [PMID: 12702077 DOI: 10.1046/j.1468-3083.2003.00431.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The Laugier-Hunziker syndrome is an acquired, idiopathic, benign mucocutaneous hypermelanosis that usually occurs on the lips and oral mucosa, although it may appear at other sites. Nails are frequently involved, mainly forming longitudinal hyperpigmented bands. We report the case of a patient that presented a typical picture of this entity, nearly 1 year after the beginning of treatment with levodopa. Two years after the first lesions occurred, she developed Addison's disease. The patient suffered from a diffuse discrete hyperpigmentation (it was more remarkable on exposed areas) and an intensification of the melanotic macules that were previously noticeable before in oral and genital mucosa, fingers, toes and nails. Hormonal replacement treatment enabled the control of laboratory and general manifestations and to decrease the degree of mucocutaneous hyperpigmentation considerably, despite initial hyperpigmented lesions persisting in described areas.
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Affiliation(s)
- J Vega Gutiérrez
- Department of Dermatology, University of Valladolid, Hospital Clinico Universitario, Avenida Ramón y Cajal, Valladolid 47005, Spain.
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Bunetel L, Le Gall F, Delaval Y, Sixou JL, Dabadie A, Bonnaure-Mallet M. An unusual oral chronic graft-versus-host disease-like syndrome following a liver transplant. J Periodontol 2003; 74:552-6. [PMID: 12747462 DOI: 10.1902/jop.2003.74.4.552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Giving the immunosuppressive drug tacrolimus (FK506) to liver transplant patients has helped to considerably reduce oral side effects such as gingival hyperplasia. Patients taking cyclosporin who suffer from gingival hyperplasia are often switched to tacrolimus. METHODS We present here a pediatric liver transplantation case study. The patient has been followed for 5.5 years. She developed oral lesions that resulted in the immunosuppressive therapy being changed from tacrolimus to cyclosporin. In clinical terms, the atypical pathology consisted of hyperpigmented patches on the gingival margin, the internal surfaces of the cheeks, and the intraoral surfaces of the lips. When located on the lips, the hyperpigmented patches were associated with pruriginous and edematous lesions. RESULTS Optical and electronic microscopic examinations of a gingival tissue sample revealed the presence of melanin incontinence and lichenoid lesions with degenerated keratinocytes and a mild infiltrate of lymphocytes. This points to a chronic graft-versus-host disease (cGvHD)-like syndrome linked to tacrolimus. This diagnosis was given further credence by improvement in the lesions following the switch to cyclosporin. CONCLUSION To our knowledge, this is the first reported case of tacrolimus-associated chronic GvHD-like syndrome occurring in the oral mucosa.
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Affiliation(s)
- Laurence Bunetel
- Laboratory of Oral Biology, Department of Pediatric Dentistry, Rennes, France.
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Affiliation(s)
- Giovanni M Gaeta
- Department of Oral Medicine Pathology, School of Dentistry, Second University of Naples, Naples, Italy
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