Pigmented Lesions
Smoker's Melanosis
aka Tobacco-Associated Pigmentation · Smoking-Related Melanosis
Diffuse brown mucosal pigmentation, particularly on anterior labial gingiva, caused by tobacco smoking.
§ figuresFigures (3)
Fig. 1Smoker's melanosis in oral mucosa with brown black pigmentation
“Smoker's melanosis” · Skinstudy · CC BY-SA 3.0 · Wikimedia Commons
Fig. 2Smoker´s melanosis a brown to black pigmentation consisting of melanin granules in the lower part of the gums epithelium. Caused by cigarette smoking.
“Smoker´s melanosis” · SK10DPB · CC BY-SA 3.0 · Wikimedia Commons
Fig. 3Smoker's melanosis in a patient consuming 2 packs of cigarette per day.
“Smoker milanosis” · Shaimaa Abdellatif · CC BY-SA 4.0 · Wikimedia Commons
Verified open-access images only, reproduced for education under their stated licences · no AI-generated or illustrative artwork · Smoker's Melanosis figures pending faculty review.
§ overviewOverview
Benign melanin hyperpigmentation of oral mucosa induced by tobacco smoke components.
§ icdICD Classification
L81.4
§ etiologyEtiology
- 01Tobacco smoke components stimulate melanin production
§ epidemiologyEpidemiology
Common in smokers; F > M (especially with OCP use). Anterior gingiva most common.
§ pathogenesisPathogenesis
Nicotine and benzopyrenes stimulate melanocyte activity → increased melanin deposition.
§ clinicalClinical Features
- 01Diffuse brown pigmentation
- 02Anterior labial gingiva, lips, buccal mucosa
- 03Intensity correlates with smoking duration
- 04Usually bilateral
§ differentialDifferential Diagnosis
- 01Physiological pigmentation
- 02Drug-induced pigmentation
- 03Addison disease
- 04Melanoma
§ histopathHistopathology
- 01Increased melanin in basal layer
- 02Melanophages in lamina propria
- 03No melanocyte proliferation or atypia
§ investigationsInvestigations
- 01Clinical + smoking history
- 02Biopsy if atypical
§ treatmentTreatment
- 01Smoking cessation (pigmentation fades over months to years)
§ prognosisPrognosis
Excellent; reversible with cessation.
§ examKey Examination Points
- 01Anterior labial gingiva
- 02Reversible with smoking cessation
- 03Distinguish from melanoma by diffuse pattern
§ revisionQuick Revision Summary
- 01Tobacco-induced melanin
- 02Anterior gingiva
- 03Fades with cessation
§ vivaBDS Viva Questions
- 01What causes smoker's melanosis?
- 02Is it reversible?
- 03How do you differentiate from melanoma?
§ mcqsMCQs — Assessment (3)
Question 1
Smoker's melanosis most commonly affects:
Question 2
Smoker's melanosis is:
Question 3
Histology shows:
References
- Neville BW. Oral & Maxillofacial Pathology, 4e
Draft — pending faculty review. Educational use only; verify against current guidelines and primary sources before clinical application.