1-53. ANGULAR CHEILITIS
Cheilitis is inflammation affecting the lips. Angular cheilitis usually begins as
redness and peeling of the skin at the angles (corners) of the mouth. As the condition
continues, cracks occur in the skin and mucous membranes at the commissure
(corners) of the lips. This condition is usually caused by infection with Candida
albicans. Other factors may also contribute to the lesions. These include vitamin B
complex deficiency and decreased vertical dimension associated with inadequate
dentures. Angular cheilitis is also a frequent finding in patients who have been infected
with the human immunodeficiency virus (HIV).
1-54. AMALGAM TATTOO
Small, pigmented areas are common in the oral mucosa and are generally
associated with tissue adjacent to restored teeth. During the placement of fillings,
amalgam may find its way into soft tissue causing a discoloration. If clinical diagnosis
can establish a definite diagnosis of amalgam tattoo, no treatment is necessary. An
amalgam tattoo (figure 1-15) may be associated with the alveolar ridge or other mucosal
tissue in patients without teeth. If there is a doubt concerning the diagnosis, a biopsy
should be done. Pigmented soft tissue tumors are not frequently found on oral mucosa;
though, when found, they range from a benign freckle to malignant melanoma.
NOTE: This pigmented palatal lesion is not directly associated with the dentition.
Amalgam particles may be found throughout the oral cavity. Amalgam particles
can generally be identified as such on radiographs. Any questionable cause of
tissue discoloration should be evaluated histologically after biopsy.
Figure 1-15. Amalgam tattoo.