A Guide to Clinical Differential Diagnosis of Oral Mucosal Lesions
Table 2. Localized Pigmented Surface Lesions of Oral Mucosa

Course Author(s): Michael W. Finkelstein, DDS, MS

Table 2. Localized Pigmented Surface Lesions of Oral Mucosa

Intravascular Blood Lesions
Usually blanch on pressure and compressible
VarixBlue; thickened; sometimes does not blanch due to thrombosis.
HemangiomaCongenital; thickened; red or blue
Kaposi sarcomaPatient is immunocompromised; may be thickened or flat.
Extravascular Blood Lesions
Do not blanch; present for less than 1 month; may have history of injury or bleeding problem.
HematomaThickened; firm to palpation.
EcchymosisNot thickened
PetechiaeFocal and pinpoint size; red; multiple; not thickened
Melanocytic Lesions
Persistent; do not blanch
Ephelis (freckle)Not thickened; located on sun-exposed surfaces.
Oral melanotic maculeNot thickened; located on mucosa not exposed to sun
NevusThickened; may be flat early in development
MelanomaThickened; may be flat early in development
Tattoo
Do not blanch; may be history of injury; radiopaque object sometimes seen on radiograph; may be thickened or flat.