In September 2008, a 5-year-old child was referred to our department for evaluation of a lesion on the mandibular mucosa that had been increasing in size over 3 months.
Intraoral examination showed a firm, well-demarcated, painless, blue-grey macula involving the alveolar mucosa in the area vestibular to the primary mandibular left canine.
The lesion failed to respond to the blanching test. There was no other unusual pigmentation on the oral mucosa or the lips, and no pathologic changes were visible on periapical radiographs of the involved mandibular region.
An excisional biopsy was performed to remove the lesion completely and analyze it.
A full mucoperiosteal flap was raised, revealing an abundance of granulation tissue and residues of solid black granules.
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Histologically, the specimen revealed interstitial edema of the corium accompanied by accumulation of solid brownish granules resembling pencil graphite.
There were no cellular atypia to suggest melanoma.
° Canadian Dental Association
° Rosario Rullo, MD / Francesco Addabbo, DDS / Vincenzo Maria Festa, DDS, PhD