Multiple intraoral melanoacanthomas: A case report with unusual findings

Melanoacanthoma is a rare, benign, mucocutaneous pigmented lesion characterized by colonization of acanthotic epithelium by dendritic melanocytes.^1,2 The most common intraoral sites are the buccal ^3,4 and masticatory mucosa subject to chronic irritation. ^1,5 The pathogenesis of oral melanoacanthoma remains uncertain, although its clinical behavior is suggestive of a reactive cause. ^3,4,6,7 The clinical appearance of melanoacanthoma is nondiagnostic, and biopsy is mandatory.^2,3,5,6,8 The lesion, however, requires no treatment⁵ and elimination of local irritants as well as periodic observation are the recommended interventions.^1,8 We describe a 39-year-old black patient with a recently reported palatal melanoacanthoma who developed additional lesions in other intraoral sites approximately 3 months after the initial lesion was biopsied. This article also documents the reactive and reversible nature of intraoral melanoacanthoma in a rare case of multiple lesions.