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Table 1 Conditions associated with mucosal pigmentation that should be considered during the differential diagnosis of oral melanosis [1, 6, 25,26,27]

From: Hyperpigmentation of the hard palate mucosa in a patient with chronic myeloid leukaemia taking imatinib

Environmental causes


 Smoking-associated melanosis


 Heavy metal pigmentation due to metallic deposit


 Dental amalgam tattoos


 Drug-induced pigmentation


Physiological causes


 Physiological ethnic and/or racial pigmentation


 Labial melanotic macule


 Oral melanocytic nevi


Pathological causes


 Post-inflammatory deposits of melanin


 Peutz–Jeghers syndrome






 Addison’s disease


 Laugier–Hunziker disease


 Oral melanoacanthoma




 Bandler’s syndrome


 McCune–Albright syndrome


 Cowden syndrome




 Riehl’s melanosis


 LAMB syndrome (Carney complex)


 Polyostotic fibrous dysplasia syndrome


 LEOPARD syndrome




 Nelson’s syndrome


 Melanosis associated with melanoma