A Rare Presentation of Congenital Melanocytic Nevus on the Tongue and Lower Lip Mucosa.
Vidhi Malu, Shubham Agarwal, Asharbh Raman
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Case in brief
A 36-year-old man had asymptomatic pigmented lesions present since childhood on the dorsal tongue and lower-lip mucosa. Examination showed hyperpigmented tongue patches and discrete lower-lip macules. Dermoscopy revealed circumscribed dark-brown to black pigment globules on the tongue and a fish-scale pattern on the lower lip. The lesions were diagnosed as oral congenital melanocytic nevi, and regular follow-up was recommended.
What made this case unusual
The nevi involved both the tongue and lower-lip mucosa, with different dermoscopic appearances at the two sites, including a fish-scale pattern on the lip.
Diagnostic / clinical pearl
Dermoscopy can help characterize oral pigmented lesions: in this case, tongue globules and a lower-lip fish-scale pattern supported the diagnosis of oral congenital melanocytic nevi.
Why it matters
The report highlights the need for follow-up of oral congenital melanocytic nevi because of their potential risk of malignant transformation.