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Pigmentierte Veränderungen der Mundschleimhaut

Pigmented lesions of the oral mucosa

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Zusammenfassung

Die Mundschleimhaut enthält auch Melanozyten, die in der weißen Bevölkerung klinisch meist nicht auffallen. Medikamentös induzierte Pigmentierungen verteilen sich mehr oder weniger gleichmäßig über die Schleimhaut der Mundhöhle (z. B. bei Einnahme von Kontrazeptiva oder Tetrazyklinen). Lokale, traumatische Pigmentierung kann auf verschmutzte Wunden mit Einsprengung von Fremdmaterial (Staub) zurückzuführen sein. Nicht selten kommt eine „Amalgamtätowierung“ vor, verursacht durch Schwermetalle nach zahnärztlichen Behandlungen mit rotierenden Instrumenten. Eine fokale Melanose ist harmlos. Neoplastische Pigmentierungen sind selten. Nävi sind kleine, meist unscharf begrenzte Läsionen. Das maligne Melanom bevorzugt den Bereich des Oberkiefers und des Gaumens. Zum Zeitpunkt der Diagnose liegen häufig bereits Metastasen vor. Die Verifizierung mittels Biopsie ist besonders wichtig, wenn eine Läsion plötzlich aufgetreten ist, bei großer Ausdehnung, Erhabenheit und unregelmäßiger Pigmentation sowie ohne erhebbare Ursache.

Abstract

The oral mucosa contains melanocytes, even though one might not suspect this when examining white subjects. Drug-induced pigmentation is usually irregularly distributed over the oral mucosa; typical causes are contraceptives and tetracyclines. Localized traumatic pigmentation can be due to injuries contaminated by foreign material (dust). Not infrequently an amalgam tattoo can be seen, caused by introduction of amalgam during dental treatment with rotating instruments. Focal melanosis is harmless. Neoplastic pigmentation is rare. Melanotic nevi are small with indistinct borders. Malignant melanoma occurs predominantly on the maxilla or hard palate. Frequently it has already metastasized by the time of diagnosis. Verification by biopsy is essential if a lesion has suddenly appeared, is extensive, elevated, with irregular pigmentation and has no obvious cause.

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  1. Univ. Klinik für Mund-, Kiefer- und Gesichtschirurgie, Paracelsus Medizinische Privatuniversität Salzburg, Müllner Hauptstr. 48, 5020, Salzburg, Österreich

    J. Beck-Mannagetta

  2. Univ. Institut für Pathologie, Paracelsus Medizinische Privatuniversität Salzburg, Salzburg, Österreich

    G. Hutarew

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  1. J. Beck-Mannagetta
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  2. G. Hutarew
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Correspondence to J. Beck-Mannagetta.

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Beck-Mannagetta, J., Hutarew, G. Pigmentierte Veränderungen der Mundschleimhaut. Hautarzt 63, 704–709 (2012). https://doi.org/10.1007/s00105-012-2351-x

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  • DOI: https://doi.org/10.1007/s00105-012-2351-x

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