Oral Melanoacanthoma
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Melanoacanthoma is a rare condition of oral mucosa that has been reported only in the last century. The lesion is characterized by a proliferation of both melanocytes and keratinocytes that results in pigmented macular or plaquelike lesions (see image below).
Oral melanoacanthoma is regarded by many as a reactive condition unrelated to cutaneous melanoacanthoma, but the histologic features are similar. Cutaneous and mucosal melanoacanthoma differ in terms of patient age, patient race, and site.
In 1927, Bloch provided the earliest known description of melanoacanthoma, which was reported in the German literature. [1] Bloch described several skin lesions, which he originally called benign nonovoid melanoepithelioma of the skin. He further subdivided his cases into 2 types: In the histologic samples studied, type 1 had both dendritic melanocytes and keratinocytes, whereas the histologic appearance of type 2 was similar to that of type 1, but it lacked the dendritic melanocytes.
In 1960, Mishima and Pinkus reexamined the condition and further refined the diagnostic terminology. [2] The condition that Bloch designated as type 1 is currently called melanoacanthoma, and type 2 is currently called pigmented seborrheic keratosis. [3]
Although cutaneous lesions of melanoacanthoma were reported as early as 1927, Tomich et al at the American Academy of Oral Pathology first reported oral mucosal lesions in 1978. [1] Although many authors subsequently published case reports, Goode et al published the first case report in 1983. [4] This was a retrospective review of 10 cases of oral melanoacanthoma reported in the literature.
To date, oral melanoacanthoma remains a rare condition, with approximately fewer than 100 reported cases. The cutaneous variant is also rare; however, it is more prevalent than the mucosal variant.
The mucosal variants of melanoacanthoma have histologic appearances similar to that of cutaneous melanoacanthoma. The lesion consists of proliferating melanocytes and keratinocytes, which result in large pigment-containing dendritic cells. The dendritic cells are present throughout the middle and upper layers of the epithelium. See the image below.
Inflammation occurs almost universally in patients with mucosal lesions. The presence of inflammation and the spontaneous resolution of oral lesions are suggestive of a reactive process rather than a neoplastic process. [5] The observation of trauma and inflammation associated with oral lesions has led to the conclusion that the mucosal variant is likely the result of a reactive process rather than a neoplastic process. [6]
The role of trauma in the development of the lesion remains controversial, but any irritant must be removed. BRAF inhibitor therapy may play a role in some cases. [7]
Oral melanoacanthoma is rare, with only approximately fewer than 100 cases reported since 1978, [8, 9, 10] when the lesions were first reported. The cutaneous variant is more common, but it is still relatively rare among skin lesions. Among all the cases reported, specific patterns are described with respect to the race, sex, and age of patients with cutaneous melanoacanthomas and those with mucosal melanoacanthomas.
Cutaneous lesions of melanoacanthoma are reported almost exclusively in white patients. The mucosal variant is reported almost exclusively in black patients. [11, 12] Some sporadic mucosal cases are reported in Asian individuals.
The prevalence for both variants of melanoacanthoma is fairly equal in both sexes, with a slight female predominance. [13] The female-to-male ratio is approximately 3:2.
The age distributions of the 2 types of melanoacanthoma differ. [14] Cutaneous lesions are found in patients with a mean age of approximately 60 years. Mucosal lesions appear in patients with a mean age of approximately 25 years.
Initially, cutaneous lesions were suspected to be malignant, and subsequently, the lesions were linked to a transformation to low-grade malignancy. Malignant transformation has been reported in at least 2 cases. However, most lesions are considered benign and should be treated conservatively.
No cases of recurrence or metastasis have been reported in either the mucosal variant or cutaneous variant. A low risk of recurrence exists. To date no malignant oral melanoacanthoma have been reported.
Schneider LC, Mesa ML, Haber SM. Melanoacanthoma of the oral mucosa. Oral Surg Oral Med Oral Pathol. 1981 Sep. 52(3):284-7. [Medline].
Wright JM, Binnie WH, Byrd DL, Dunsworth AR. Intraoral melanoacanthoma. J Periodontol. 1983 Feb. 54(2):107-11. [Medline].
Roh NK, Hahn HJ, Lee YW, Choe YB, Ahn KJ. Clinical and Histopathological Investigation of Seborrheic Keratosis. Ann Dermatol. 2016 Apr. 28 (2):152-8. [Medline]. [Full Text].
Goode RK, Crawford BE, Callihan MD, Neville BW. Oral melanoacanthoma. Review of the literature and report of ten cases. Oral Surg Oral Med Oral Pathol. 1983 Dec. 56(6):622-8. [Medline].
Cantudo-Sanagustín E, Gutiérrez-Corrales A, Vigo-Martínez M, Serrera-Figallo MÁ, Torres-Lagares D, Gutiérrez-Pérez JL. Pathogenesis and clinicohistopathological caractheristics of melanoacanthoma: A systematic review. J Clin Exp Dent. 2016 Jul. 8 (3):e327-36. [Medline]. [Full Text].
Horlick HP, Walther RR, Zegarelli DJ, Silvers DN, Eliezri YD. Mucosal melanotic macule, reactive type: a simulation of melanoma. J Am Acad Dermatol. 1988 Nov. 19(5 Pt 1):786-91. [Medline].
Boussemart L, Girault I, Malka-Mahieu H, Mateus C, Routier E, Rubington M, et al. Secondary Tumors Arising in Patients Undergoing BRAF Inhibitor Therapy Exhibit Increased BRAF-CRAF Heterodimerization. Cancer Res. 2016 Mar 15. 76 (6):1476-84. [Medline].
Contreras E, Carlos R. Oral melanoacanthosis (melanoachantoma): report of a case and review of the literature. Med Oral Patol Oral Cir Bucal. 2005 Jan-Feb. 10(1):11-2; 9-11. [Medline].
Fornatora ML, Reich RF, Haber S, Solomon F, Freedman PD. Oral melanoacanthoma: a report of 10 cases, review of the literature, and immunohistochemical analysis for HMB-45 reactivity. Am J Dermatopathol. 2003 Feb. 25(1):12-5. [Medline].
Frey VM, Lambert WC, Seldin RD, Schneider LC, Mesa ML. Intraoral melanoacanthoma. J Surg Oncol. 1984 Oct. 27(2):93-6. [Medline].
Carlos-Bregni R, Contreras E, Netto AC, Mosqueda-Taylor A, Vargas PA, Jorge J, et al. Oral melanoacanthoma and oral melanotic macule: a report of 8 cases, review of the literature, and immunohistochemical analysis. Med Oral Patol Oral Cir Bucal. 2007 Sep 1. 12(5):E374-9. [Medline].
Tomich CE, Zunt SL. Melanoacanthosis (melanoacanthoma) of the oral mucosa. J Dermatol Surg Oncol. 1990 Mar. 16(3):231-6. [Medline].
Yarom N, Hirshberg A, Buchner A. Solitary and multifocal oral melanoacanthoma. Int J Dermatol. 2007 Dec. 46(12):1232-6. [Medline].
Chandler K, Chaudhry Z, Kumar N, Barrett AW, Porter SR. Melanocanthoma: a rare cause of oral hyperpigmentation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Nov. 84(5):492-4. [Medline].
Flaitz CM. Oral melanoacanthoma of the attached gingiva. Am J Dent. 2000 Jun. 13(3):162. [Medline].
Matsuoka LY, Glasser S, Barsky S. Melanoacanthoma of the lip. Arch Dermatol. 1979 Sep. 115(9):1116-7. [Medline].
Sexton FM, Maize JC. Melanotic macules and melanoacanthomas of the lip. A comparative study with census of the basal melanocyte population. Am J Dermatopathol. 1987 Oct. 9(5):438-44. [Medline].
Whitt JC, Jennings DR, Arendt DM, Vinton JR. Rapidly expanding pigmented lesion of the buccal mucosa. J Am Dent Assoc. 1988 Oct. 117(5):620-2. [Medline].
Muco-cutaneous Keratoacanthoma Involving Maxillary Lip. Mattoo KA, Singh M, Singh V. Oral Surg Oral Med Oral Rad. 2014. 2(2):20-21. [Full Text].
Fatahzadeh M, Sirois DA. Multiple intraoral melanoacanthomas: a case report with unusual findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Jul. 94(1):54-6. [Medline].
Buchner A, Merrell PW, Carpenter WM. Relative frequency of solitary melanocytic lesions of the oral mucosa. J Oral Pathol Med. 2004 Oct. 33(9):550-7. [Medline].
Sen S, Samanta A, Majumdar B, Jain A, Behra A, Mishra P. “Nevoid Eruptive Keratoacanthoma” – Yet Another Atypical Manifestation of Generalized Keratoacanthoma. Indian J Dermatol. 2016 Jan-Feb. 61 (1):106-7. [Medline].
Kanzaki A, Kudo M, Ansai S, Peng WX, Ishino K, Yamamoto T, et al. Insulin-like growth factor 2 mRNA-binding protein-3 as a marker for distinguishing between cutaneous squamous cell carcinoma and keratoacanthoma. Int J Oncol. 2016 Mar. 48 (3):1007-15. [Medline].
Shahriari N, Grant-Kels JM, Rabinovitz HS, Oliviero M, Scope A. In vivo reflectance confocal microscopy features of a melanoacanthoma. Dermatol Pract Concept. 2016 Oct. 6 (4):27-30. [Medline]. [Full Text].
Lambert WC, Lambert MW, Mesa ML, Schnieder LC, Fischman GJ, Abbey AH, et al. Melanoacanthoma and related disorders. Simulants of acral-lentiginous (P-P-S-M) melanoma. Int J Dermatol. 1987 Oct. 26(8):508-10. [Medline].
Wright JM. Intraoral melanoacanthoma: a reactive melanocytic hyperplasia. Case report. J Periodontol. 1988 Jan. 59(1):53-5. [Medline].
Krahl D, Altenburg A, Zouboulis CC. Reactive hyperplasias,precancerous and malignant lesions of the oral mucosa. J Dtsch Dermatol Ges. 2008 Mar. 6(3):217-32. [Medline].
Heine BT, Drummond JF, Damm DD, Heine RD 2nd. Bilateral oral melanoacanthoma. Gen Dent. 1996 Sep-Oct. 44(5):451-2. [Medline].
Andrews BT, Trask DK. Oral melanoacanthoma: a case report, a review of the literature, and a new treatment option. Ann Otol Rhinol Laryngol. 2005 Sep. 114(9):677-80. [Medline].
Talib Najjar, DMD, MDS, PhD Professor of Oral and Maxillofacial Surgery and Pathology, Rutgers School of Dental Medicine
Talib Najjar, DMD, MDS, PhD is a member of the following medical societies: American Society for Clinical Pathology
Disclosure: Nothing to disclose.
Thomas A Chiodo, DDS Staff Dentist, Department of Oral and Maxillofacial Surgery, University of Medicine and Dentistry of New Jersey; Private Practice, Oral and Maxillofacial Surgery
Thomas A Chiodo, DDS is a member of the following medical societies: American Association of Oral and Maxillofacial Surgeons, American Dental Association
Disclosure: Nothing to disclose.
Nathan Wuebbels, DMD, MD Staff Physician, Department of Oral and Maxillofacial Surgery, University of Medicine and Dentistry, New Jersey, University Hospital
Nathan Wuebbels, DMD, MD is a member of the following medical societies: American Association of Oral and Maxillofacial Surgeons, American Dental Association, American Student Dental Association
Disclosure: Nothing to disclose.
Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology
Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association
Disclosure: Nothing to disclose.
Jeffrey J Miller, MD Associate Professor of Dermatology, Pennsylvania State University College of Medicine; Staff Dermatologist, Pennsylvania State Milton S Hershey Medical Center
Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Society for Investigative Dermatology, Association of Professors of Dermatology, North American Hair Research Society
Disclosure: Nothing to disclose.
Jeff Burgess, DDS, MSD (Retired) Clinical Assistant Professor, Department of Oral Medicine, University of Washington School of Dental Medicine; (Retired) Attending in Pain Center, University of Washington Medical Center; (Retired) Private Practice in Hawaii and Washington; Director, Oral Care Research Associates
Disclosure: Nothing to disclose.
Neil Shear, MD Professor and Chief of Dermatology, Professor of Medicine, Pediatrics and Pharmacology, University of Toronto Faculty of Medicine; Head of Dermatology, Sunnybrook Women’s College Health Sciences Center and Women’s College Hospital, Canada
Neil Shear, MD is a member of the following medical societies: Canadian Medical Association, Ontario Medical Association, Royal College of Physicians and Surgeons of Canada, Canadian Dermatology Association, American Academy of Dermatology, American Society for Clinical Pharmacology and Therapeutics
Disclosure: Nothing to disclose.
Oral Melanoacanthoma
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