Physiological<unk>  Physiological<unk>  is considered of normal variation. However, for some individuals, the brown/black discolouration may be aesthetically displeasing. It may cause embarrassment or discomfort for some, particularly when smiling or talking. Some methods used to eliminate or reduce this<unk>  include gingivectomy, laser therapy and cryosurgery. There are pros and cons for each type of management strategy. Cryotherapy is one of the most successful and popular treatments for<unk>  melanosis. Cryotherapy damages the tissue by freezing its internal components – thereby jeopardising the cells' optimum temperature; leading to denaturation of enzymes and proteins required for cell function. Minimum temperature needed for cell damage is cell specific, and melanocytes are very sensitive to low temperatures at −4 °C to −7 °C where cell death can occur. This procedure is relatively pain free, so local anaesthesia is generally not needed. Immediately after, slight erythema of the gingiva becomes apparent. Superficial necrosis is observed over the next few days and a whitish slough could be separated from the underlying tissue leaving a clean pink ulcer bed. Within a week, the gingiva returns to normal and is fully healed in next few weeks minus the<unk> . In conclusion, cryotherapy has been described as the most suitable treatment options for physiological<unk>  melanosis. It is simple yet effective method for treating<unk>  with minimal trauma to the patient. Alternatively, lasers can be used to treat physiological<unk>  melanosis. There are many different lasers available on the market to purchase, each with their own individual benefits and disadvantages. These lasers are expensive therefore, not commonly available in a hospital or clinical setting. However, lasers allow for controlled cutting with a limited depth of necrosis. Studies have shown the diode laser is a safe method and is the preferred laser when no other short pulse lasers are available. The diode laser is specific and is absorbed only by the melanin meaning more selective destruction and less damage to surrounding normal tissue with comparison to CO2 lasers. Systemic conditions associated with<unk> <unk>  melanosis caused by systemic diseases may be the first sign a dentist or medical professional may pick up to cause suspicion for any underlying systemic disease. Most diseases are treated with the relevant medications which leads to a gradual decrease in<unk>  melanosis. For example, Addison’s disease causes hyperpigmentation in the mouth and may be noticed during an exam followed alongside other systemic symptoms. An<unk>  biopsy alongside other relevant tests (ie bloods) should be taken and confirmed for diagnosis for any type of<unk>  melanosis which you suspect to be caused by an underlying disease. For Addison’s, the specific treatment option would be to treat with glucocorticoids and mineralocorticoids. Alternatively, the continuous exposure to high concentrations of corticosteroids increases susceptibility to Cushing’s syndrome which is also a cause of<unk>  melanosis. The patterns of<unk>  are very similar to those with Addison’s. The management of these depend on the severity and can be removed by surgical, radiation or drug therapy ie Pasierotide. With regards to<unk>  melanosis caused by systemic diseases, the most important thing to do is to refer the patient to their GMP if there is a suspicion of any underlying systemic cause. If suitable, then it would be appropriate to carry out the relevant investigation to come to a definitive diagnosis. From here it will be easier to manage the cause with the relevant medication or therapy. Kaposi's sarcoma There is a variety of different treatment options for Kaposi sarcoma. The appropriate therapy options may vary depending on the variation of disease and the patients immune status. If the lesion is localised, usually found in classical Kaposi sarcoma, and not systemic treatments can be any from lasers, cryotherapy, non-intervention, chemotherapy and immune upregulation. For generalized and systemic cases chemotherapeutic drugs are used. HAART is also a recognised treatment if the patient is known to suffer from AIDS-related Kaposi sarcoma. For cases of iatrogenic Kaposi sarcoma any immunosuppressive medication should be stopped or reduced if able. Smoker's melanosis Smokers melanosis may resolve over several years following smoking cessation.<unk>  melanoma An initial biopsy of the lesion may be carried out first to determine correct diagnosis. Following this there is a number of different treatment options available. The combination used will be based on the individual patient and presenting melanoma. Surgical resection is most commonly carried out. This involves cutting out the lesion and ensuring complete removal from the<unk>  cavity. Chemotherapy and Radiotherapy are considered first line management and they may be used in conjunction with surgery. Another option available is Immunotherapy. The aim of this is to target cells or molecules in the immune system in an effort to destroy tumours. This can be done by suppressing or stimulating the patients immune system. After treatment has been carried out patients should be seen for regular follow ups to manage any reoccurrence early and ensure complete healing following surgeries. If the melanoma has progressed extensively and metastasised, treatment, for example surgery, would be carried out in a palliative nature only.
Oral pigmentation
Nipple pigmentation
Breast hypertrophy
Hypopigmentation
Trichomegaly
Blue nails
Tooth discoloration
Green nails