Pigmented Lesions
Oral Nevus
aka Intraoral Melanocytic Nevus · Mole
Benign melanocytic neoplasm of oral mucosa; less common than cutaneous nevus.
Common type
Intramucosal
Site
Palate / gingiva
Rx
Excisional biopsy
§ overviewOverview
Benign proliferation of nevus cells (modified melanocytes) in oral mucosa.
§ icdICD Classification
D22.9
§ etiologyEtiology
- 01Unknown; possibly from neural crest migration
§ epidemiologyEpidemiology
Uncommon; palate and gingiva most common sites.
§ pathogenesisPathogenesis
Nevus cells aggregate in nests at junction, dermis, or both.
§ clinicalClinical Features
- 01Well-circumscribed, brown to blue-black macule or papule
- 02Commonly on hard palate
- 03Usually <6 mm
§ differentialDifferential Diagnosis
- 01Melanoma
- 02Melanotic macule
- 03Amalgam tattoo
- 04Kaposi sarcoma
§ histopathHistopathology
- 01Nests of nevus cells at specified location
- 02Blue nevus: spindle cells with melanin deep in CT
§ investigationsInvestigations
- 01Excisional biopsy
§ classificationClassification
- 01Junctional nevus (nests at epithelial-connective tissue junction)
- 02Compound nevus (junctional + intradermal)
- 03Intramucosal nevus (nests in connective tissue only)
- 04Blue nevus (deep dermal, spindle cells)
§ treatmentTreatment
- 01Excisional biopsy for diagnosis
- 02No further treatment if benign
§ prognosisPrognosis
Excellent; malignant transformation rare.
§ examKey Examination Points
- 01Palate most common site
- 02Blue nevus may be raised, deeply pigmented
- 03Biopsy to rule out melanoma
§ revisionQuick Revision Summary
- 01Intramucosal most common type in mouth
- 02Palate/gingiva sites
- 03Excise for diagnosis
§ vivaBDS Viva Questions
- 01Classify oral nevi.
- 02How do you differentiate from melanoma?
- 03Describe blue nevus.
§ mcqsMCQs — Assessment (3)
Question 1
Most common type of oral nevus:
Question 2
Blue nevus is characterised by:
Question 3
Most common site for oral nevus:
References
- Neville BW. Oral & Maxillofacial Pathology, 4e
Draft — pending faculty review. Educational use only; verify against current guidelines and primary sources before clinical application.