Carpenter W M, Rudd M
Department of Pathology and Medicine, University of the Pacific School of Dentistry, 2155 Webster St., San Francisco, CA 94115, USA.
J Calif Dent Assoc. 2000 Dec;28(12):949-54.
The purpose of this article is to assist the clinician in establishing a clinical approach to the diagnosis of focal, flat pigmentations of the oral mucosa. These pigmentations include lesions that may be blue, purple, red, black, or brown. The etiopathogenesis may be variable and the pigment may originate from an exogenous (extrinsic) or endogenous (intrinsic) source. Exogenous pigmentations are of a traumatic or iatrogenic origin. Intrinsic pigmentations are either vascular or melanocytic. Clinical approaches include a thorough history and physical exam coupled with diascopy (blanchability), radiographs, and tissue examination (biopsies). An algorithm is presented to clarify the diagnostic approach. The diagnosis may vary from pathologic entities that require no treatment to others that may involve malignancies and their associated management. It is therefore extremely important that these lesions are identified and properly managed in an expeditious manner.
本文的目的是帮助临床医生建立一种针对口腔黏膜局灶性扁平色素沉着的临床诊断方法。这些色素沉着包括可能呈蓝色、紫色、红色、黑色或棕色的病变。其发病机制可能各不相同，色素可能来源于外源性（外部）或内源性（内部）。外源性色素沉着源于创伤或医源性因素。内源性色素沉着要么是血管性的，要么是黑素细胞性的。临床方法包括全面的病史和体格检查，以及透照检查（压之褪色情况）、X线片检查和组织检查（活检）。本文还给出了一个诊断方法流程图以阐明诊断思路。诊断结果可能从无需治疗的病理实体到可能涉及恶性肿瘤及其相关治疗的情况各不相同。因此，迅速识别并妥善处理这些病变极其重要。
