Lesiones pigmentadas en cavidad bucal y la importancia de un diagnóstico precoz. Revisión de literatura Las lesiones pigmentadas de la cavidad bucal constituyen un grupo heterogéneo. El esquema diagnóstico es diverso, varía desde una condición fisiológica, un proceso reactivo localizado, una enfermedad sistémica, mientras que otros pueden ser procesos neoplásicos. Se clasifican clínicamente como una pigmentación focal o difusa. Pueden parecerse mucho entre sí, por lo que es importante que el odontólogo pueda reconocer las características clínicas distintivas de enfermedades benignas o no. El objetivo de este artículo consistió en realizar una descripción de las principales lesiones pigmentadas en cavidad oral y la importancia de un diagnóstico temprano de lesiones malignas. Resaltando la relevancia que tiene el realizar una buena historia y examen clínico, apoyándose en pruebas diagnósticas y realizar un estudio histopatológico a tiempo, para la buena supervivencia y la calidad de vida de una persona paciente. The pigmented lesions of the oral cavity represent a heterogeneous group. The diagnostic structure is diverse, ranging from a physiological condition, a localized reactive process, or a systemic disease, while others may be neoplastic processes. They can be clinically classified as focal or diffuse pigmentation. They can look very similar to each other, so it is important for the dentist to have the ability to recognize the distinctive clinical features of benign and non-benign conditions. The purpose of this article was to make a description of the main pigmented lesions in the oral cavity and the importance of making an early diagnosis of malignant lesions. Emphasizing the relevance of performing a good medical history and clinical examination, and performing a histopathological study on time, for good survival and long-term wellbeing of the patient. Maycol Rivera Álvarez Costa Rica Universidad de Costa Rica Mónica Esquivel Umaña Costa Rica Universidad de Costa Rica Silvia Ovares Saballos Costa Rica Yadira V. Boza Oreamuno Costa Rica Universidad de Costa Rica yadira.boza@ucr.ac.cr Agrawal, R., Chauhan, A. y Kumar, P. (2015). Spectrum of Oral Lesions in A Tertiary Care Hospital. Journal of Clinical and Diagnostic Research : JCDR, 9(6), EC11–EC13. https://doi.org/10.7860/JCDR/2015/13363.6121 Aljanobi, H. A., Alshuyukh, M. H., Husain, M. S. y Alqahtani, W. M. (2022). Multifocal Intraoral Melanoacanthomas: Two Case Reports and a Literature Review. Cureus, 14(7). https://doi.org/10.7759/cureus.26946 Arava-Parastatidis, M., Alawi, F. y Stoopler, E. T. (2011). Multifocal pigmentation of the oral cavity. Journal of the American Dental Association, 142(1), 53–56. https://doi.org/10.14219/jada.archive.2011.0028 Buchner, A., Merrell, P. W. y Carpenter, W. M. (2004). Relative frequency of solitary melanocytic lesions of the oral mucosa. Journal of Oral Pathology and Medicine, 33(9), 550–557. https://doi.org/10.1111/j.1600-0714.2004.00238.x Cantudo-Sanagustín, E., Gutiérrez-Corrales, A., Vigo-Martínez, M., Serrera-Figallo, M. ángeles, Torres- Lagares, D. y Gutiérrez-Pérez, J. L. (2016). Pathogenesis and clinicohistopathological caractheristics of melanoacanthoma: A systematic review. Journal of Clinical and Experimental Dentistry, 8(3), e327–e336. https://doi.org/10.4317/jced.52860 da Silva, W. B., Ribeiro, A. L. R., de Menezes, S. A. F., de Jesus Viana Pinheiro, J. y de Melo Alves-Junior, S. (2014). Oral capillary hemangioma: A clinical protocol of diagnosis and treatment in adults. Oral and Maxillofacial Surgery, 18(4), 431–437. https://doi.org/10.1007/s10006-013-0436-z de-Andrade, B. A. B., Toral-Rizo, V. H., León, J. E., Contreras, E., Carlos, R., Delgado-Azañero, W., Mosqueda-Taylor, A. y de-Almeida, O. P. (2012). Primary oral melanoma: A histopathological and immunohistochemical study of 22 cases of Latin America. Medicina Oral, Patologia Oral y Cirugia Bucal, 17(3), 15–20. https://doi.org/10.4317/medoral.17588 Delgado Azañero, W. A. y Mosqueda Taylor, A. (2003). Un método práctico para el diagnostico clínico de melanomas de la mucosa oral. Medicina Oral, 8(5), 348–352. Dhanuthai, K., Theungtin, N., Theungtin, N., Thep-Akrapong, P., Kintarak, S., Klanrit, P., Chamusri, N. y Sappayatosok, K. (2022). Pigmented Oral Lesions: A Multicenter Study. European Journal of Dentistry, 16(2), 315–319. https://doi.org/10.1055/s-0041-1735790 Dika, E., Lambertini, M., Pellegrini, C., Veronesi, G., Melotti, B., Riefolo, M., Sperandi, F., Patrizi, A., Ricci, C., Mussi, M. y Fargnoli, M. C. (2021). Cutaneous and mucosal melanomas of uncommon sites: Where do we stand now? Journal of Clinical Medicine, 10(3), 1–15. https://doi.org/10.3390/jcm10030478 Dika, E., Starace, M., Lambertini, M., Patrizi, A., Veronesi, G., Alessandrini, A. y Piraccini, B. M. (2020). Oral and nail pigmentations: a useful parallelism for the clinician. JDDG - Journal of the German Society of Dermatology, 18(1), 7–14. https://doi.org/10.1111/ddg.14023 Donnell, C. C., Walton, R. L. y Carrozzo, M. (2021). The blue palate—A case series of imatinib-related oral pigmentation and literature review. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 131(1), 49–61. https://doi.org/10.1016/j.oooo.2020.10.015 Duong, B. T. y Winship, I. (2017). The role of STK 11 gene testing in individuals with oral pigmentation. Australasian Journal of Dermatology, 58(2), 135–138. https://doi.org/10.1111/ajd.12443 Feller, L., Masilana, A., Khammissa, R. A. G., Altini, M., Jadwat, Y. y Lemmer, J. (2014). Melanin: The biophysiology of oral melanocytes and physiological oral pigmentation. Head and Face Medicine, 10(1), 1–7. https://doi.org/10.1186/1746-160X-10-8 Ferreira, L., Jham, B., Assi, R., Readinger, A. y Kessler, H. P. (2015). Oral melanocytic nevi: A clinicopathologic study of 100 cases. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 120(3), 358–367. https://doi.org/10.1016/j.oooo.2015.05.008 Gondak, R. O., da Silva-Jorge, R., Jorge, J., Lopes, M. A. y Vargas, P. A. (2012). Oral pigmented lesions: Clinicopathologic features and review of the literature. Medicina Oral, Patologia Oral y Cirugia Bucal, 17(6). https://doi.org/10.4317/medoral.17679 Hassona, Y., Sawair, F., Al-karadsheh, O. y Scully, C. (2016). Prevalence and clinical features of pigmented oral lesions. International Journal of Dermatology, 55(9), 1005–1013. https://doi.org/10.1111/ijd.13133 Kauzman, A., Pavone, M., Blanas, N. y Bradley, G. (2004). Pigmented Lesions Of The Oral Cavity Review And Differential Diagnosis. Journal of the Canadian Dental Association, 70(10), 682-683g. https://doi.org/10.36503/chcmj2(2)-06 Ko, E. y Panchal, N. (2020). Pigmented Lesions. Dermatologic Clinics, 38(4), 485–494. https://doi.org/10.1016/j.det.2020.05.009 Laimer, J., Henn, R., Helten, T., Sprung, S., Zelger, B., Zelger, B., Steiner, R., Schnabl, D., Offermanns, V., Bruckmoser, E. y Huck, C. W. (2018). Amalgam tattoo versus melanocytic neoplasm - Differential diagnosis of dark pigmented oral mucosa lesions using infrared spectroscopy. PLoS ONE, 13(11), 1– 14. https://doi.org/10.1371/journal.pone.0207026 Lambertini, M., Patrizi, A., Fanti, P. A., Melotti, B., Caliceti, U., Magnoni, C., Misciali, C., Baraldi, C., Ravaioli, G. M. y Dika, E. (2018). Oral melanoma and other pigmentations: when to biopsy? Journal of the European Academy of Dermatology and Venereology, 32(2), 209–214. https://doi.org/10.1111/jdv.14574 Ma, Y., Xia, R., Ma, X., Judson-Torres, R. L. y Zeng, H. (2021). Mucosal Melanoma: Pathological Evolution, Pathway Dependency and Targeted Therapy. Frontiers in Oncology, 11(July), 1–16. https://doi.org/10.3389/fonc.2021.702287 Maymone, M. B. C., Greer, R. O., Burdine, L. K., Dao-Cheng, A., Venkatesh, S., Sahitya, P. C., Maymone, A. C., Kesecker, J. y Vashi, N. A. (2019). Benign oral mucosal lesions: Clinical and pathological findings. Journal of the American Academy of Dermatology, 81(1), 43–56. https://doi.org/10.1016/j.jaad.2018.09.061 McNamara, K. K. y Kalmar, J. R. (2019). Erythematous and Vascular Oral Mucosal Lesions: A Clinicopathologic Review of Red Entities. Head and Neck Pathology, 13(1), 4–15. https://doi.org/10.1007/s12105-019-01002-8 Mısır, A. F., Durmuşlar, M. C., Zerener, T. y Gün, B. D. (2016). Primary malignant melanoma. Saudi Medical Journal, 37(4), 446–449. https://doi.org/10.15537/smj.2016.4.15017 Natarajan, E. (2019). Black and Brown Oro-facial Mucocutaneous Neoplasms. Head and Neck Pathology, 13(1), 56–70. https://doi.org/10.1007/s12105-019-01008-2 Patil, S., Raj, T., Rao, R. y Warnakulasuriya, S. (2015). Pigmentary Disorders of Oral Mucosa. Journal of Pigmentary Disorders, 2(11). https://doi.org/10.4172/2376-0427.1000225 Peeran, S. W., Ramalingam, K., Peeran, S. A., Altaher, O. B., Alsaid, F. M. y Mugrabi, M. H. (2014). Gingival pigmentation index proposal of a new index with a brief review of current indices. European Journal of Dentistry, 8(2), 287–290. https://doi.org/10.4103/1305-7456.130640 Rodrigues, B. T. G., Cunha, J. L. S., Albuquerque, D. M. da S., Chagas, W. P. das, Freire, N. de A., Agostini, M., Canedo, N. H. S., Júnior, R. L. C. de A., de Sousa, S. F., Abrahão, A. C., Romañach, M. J., de Almeida, O. P., Israel, M. S. y Andrade, B. A. B. de. (2021). Primary melanoma of the oral cavity: A multi- institutional retrospective analysis in Brazil. Medicina Oral Patologia Oral y Cirugia Bucal, 26(3), e379–e386. https://doi.org/10.4317/medoral.24240 Rosebush, M. S., Briody, A. N. y Cordell, K. G. (2019). Black and Brown: Non-neoplastic Pigmentation of the Oral Mucosa. Head and Neck Pathology, 13(1), 47–55. https://doi.org/10.1007/s12105-018- 0980-9 Sandru, F., Petca, A., Dumitrascu, M., Petca, R.-C. y Carsote, M. (2021). Peutz‐Jeghers syndrome: Skin manifestations and endocrine anomalies (Review). Experimental and Therapeutic Medicine, 22(6), 1–7. https://doi.org/10.3892/etm.2021.10823 Shahna, N., Suchetha, A., Sapna, N. y Bm, D. (2019). Gingival pigmentation : A review of literature. International Journal of Applied Dental Sciences, 5(2), 83–91. Tarakji, B., Umair, A., Prasad, D. y Alsakran Altamimi, M. (2014). Diagnosis of oral pigmentations and malignant transformations. Singapore Dental Journal, 35, 39–46. https://doi.org/10.1016/j.sdj.2014.03.001 Tavares, T. S., Meirelles, D. P., de Aguiar, M. C. F. y Caldeira, P. C. (2018). Pigmented lesions of the oral mucosa: A cross-sectional study of 458 histopathological specimens. Oral Diseases, 24(8), 1484– 1491. https://doi.org/10.1111/odi.12924 Tsao, H., Olazagasti, J. M., Cordoro, K. M., Brewer, J. D., Taylor, S. C., Bordeaux, J. S., Chren, M. M., Sober, A. J., Tegeler, C., Bhushan, R. y Begolka, W. S. (2015). Early detection of melanoma: Reviewing the ABCDEs American Academy of Dermatology Ad Hoc Task Force for the ABCDEs of Melanoma. Journal of the American Academy of Dermatology, 72(4), 717–723. https://doi.org/10.1016/j.jaad.2015.01.025 Tziveleka, S., Georgaki, M., Pettas, E., Savva, V., Papadopoulou, E., Katafygiotis, P., Vardas, E., Piperi, E. y Nikitakis, N. G. (2022). Acquired Compound Melanocytic Nevus on the Palate of a Child: Report of a Case. Journal of Oral and Maxillofacial Research, 13(1), 1–7. https://doi.org/10.5037/jomr.2022.13105 Vera-Sirera, B., Risueño-Mata, P., Ricart-Vayá, J. M., Baquero Ruíz de la Hermosa, C. y Vera-Sempere, F. (2012). Estudio clínicopatológico e inmunohistoquímico de la pigmentación oral por amalgama. Acta Otorrinolaringologica Espanola, 63(5), 376–381. https://doi.org/10.1016/j.otorri.2012.02.004 Yuan, A. y Woo, S. Bin. (2015). Adverse drug events in the oral cavity. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 119(1), 35–47. https://doi.org/10.1016/j.oooo.2014.09.009