Solitary Pigmented Melanocytic Lesion on the Palatal and Gingival Mucosa : Should It Rise Dentist's Concerns?

Background: Solitary pigmented melanocytic lesions of the oral mucosa are sometimes presented asymptomatically. Therefore, the patient does not realize their presence. To establish a diagnosis is challenging since there are similarities with other lesions. Once pigmented lesions on the oral mucosa are found, we need to do a proper diagnosis pathway to rule out the possibility of missing the detection of a malignant lesion. This report presents a case of pigmented oral mucosa located on the palatal and gingival mucosa that had to raise the suspicion to malignant pigmented lesion. Case Report and Management: A 46-years-old female with an asymptomatic dark bluish hue at the right hard palate towards the soft palate with a purplish at the 48-retro molar pad area for ten years ago, until a family general dentist concerned about the lesion and made the referral to our Dental Hospital. Based on the history and clinical assessment of the lesion using a diagnostic pathway, a provisional diagnosis of oral malignant melanoma was made. The biopsy for histopathological evaluation was decided. However, some obstacles prevent the patient to do the procedure. The differences in the level of awareness about pigmented lesion in the oral mucosa of the dentists involve in this patient care complicated the process of diagnosis of the lesion. Conclusion: The dentist's awareness on the possibility of finding a nonbenign lesion in the oral cavity is needed. It is important for the dentist to make a diagnosis pathway when finding pigmented oral mucosal lesion.