II. Causes
- See Medication Causes of Hyperpigmentation
-
Adrenal Insufficiency
- May be associated with Candidiasis in autoimmune polyendocrinopathy-Candidiasis-ectodermal dystrophy syndrome
- Darker pigmentation related to ethnicity
- Tobacco Abuse
- Medication Causes of Hyperpigmentation
- Neurofibromatosis 1
- McCune-Albright Syndrome
- Peutz-Jeghers Syndrome
III. Differential Diagnosis
- See Tooth Discoloration
- Oral Melanoma
- Rare, but devastating outcomes if missed when early, focal
IV. Management
- Exclude Melanoma
- Eliminate or reduce dosing of causative agents
- Consider Tooth Discoloration causes that may be discoloring mucosa as well
- Refractory cases
- Surgical mucosal stripping of hyperpigmented tissue (e.g. laser, Cryotherapy, scalpel)