1. 口腔診斷學 陳玉昆副教授 : 高雄醫學大學 口腔病理科 07-3121101~2755 yukkwa@kmu.edu.tw Intraoral brown, bluish and black conditions 口腔棕色、藍色、黑色疾病

2. Understanding: 1. Intraoral brown, bluish and black conditions 學 習 目 標學 習 目 標

3. 1.Kaohsiung Medical University, Oral Pathology Department 2.Cawson RA: Oral Diseases. 3rd Ed., pp. 11.2-11.10 3.Cawson RA: Oral Diseases. 3rd Ed., pp. 11.12 4.Cawson RA: Oral Diseases. 3rd Ed., pp. 11.13 5.AFIP (American air-force institute of pathology) References: 參考資料

4. Melanin Blood Ref. 1

5. Hairy tongue Localized pigmented Endocrine disorder Brownish, Blackish Pigmented Lesions Exogenous Endogenous

6. Melanocyte Stimulating Hormone Tyrosinase Ref. 2 Intraoral brown and black conditions

7. NormalLentigo simplex Junctional activity Compound nevus Intramucosal nevusBlue nevus Ref. 2 Intraoral brown and black conditions

8. Junctional activity Intramucosal nevus Compound nevus IntraoralCutaneous Limina propria Refs. 1, 2 Intraoral brown and black conditions

9. Epithelium Pigmented basal cell Melanophage Pigmented basal keratinocyte Refs. 1, 2 Intraoral brown and black conditions Oral Melanotic Macule

10. Amalgam Tatto Amalgam restoration Amalgam retrograde filling Refs. 1, 3 Intraoral brown and black conditions

11. Graphite Tatto Ref. 1 Intraoral brown and black conditions

12. Hairy Tongue Ref. 1 Intraoral brown and black conditions

13. Early Changes of Melanoma 1.Appear recently 2.Change in degree of pigmentation 3.Bleeding or ulceration 4.Rapid growth (in size or elevated) Refs. 1, 2

14. Melanoma Ref. 1

15. Melanoma Ref. 1

16. Melanoma Ref. 1

17. Melanoma Ref. 1

18. Melanoma Ref. 1 Immunohistochemical staining of HMB-45 (A) and S-100 (B) revealed diffuse positivity in the tumor cells.

19. Von Reclinghausen’s disease of skin multiple neurofibroma Cafa-Au-Lait-spot Ref. 5

20. Cafa-Au-Lait-spot Ref. 1

21. Addison’s Disease Pituitary Gland ACTH Gluco-cortisoid (Hydrocortisone) Blood circulation product Cause adrenal produce Into Ref. 4

22. Peutz-Jeghers Syndrome Bluish black macules Skin pigment but not oral tends fade with age Intestinal polyp Refs. 1

23. HemangiomaMucocele Eruption cystHematoma Bluish Lesions Ref. 1

24. Varicoses Ref. 1

25. Mucoepidermoid Carcinoma Ref. 1

26. Knowing how to differentiate brown, bluish & black oral conditions SUMMARY