Laugier-Hunziker syndrome (LHS) is a rare, acquired mucocutaneous hyperpigmentation often associated with longitudinal melanonychia. The clinical behavior of mucocutaneous pigmented lesions ranges from benign to highly malignant. Therefore, in most cases, the clinical diagnosis should be confirmed by further diagnostic methods. Dermoscopy is a noninvasive technique that has been used to make more accurate diagnoses of pigmented skin lesions. Nevertheless, to our knowledge, the dermoscopic features of the pigmented lesions in LHS have not been described previously. Herein, we report a case of LHS together with its dermoscopic features.
The clinical examination revealed macular hyperpigmentation on the oral and genital mucosa, conjunctiva, and palmoplantar region together with longitudinal melanonychia. Dermoscopic examination of mucosal lesions on the patient's lips and vulva revealed a parallel pattern. Longitudinal homogeneous pigmentation was observed on the toenails. The pigmented macules on the palms and the sole showed a parallel furrow pattern. A skin biopsy sample taken from the labial lesion was compatible with a diagnosis of mucosal melanosis.
By means of this case report, the dermoscopic features of the pigmented lesions in LHS are described for the first time, which facilitates diagnosis with a noninvasive technique. Future reports highlighting the dermoscopic features of this syndrome may simplify the diagnosis of LHS, which is thought to be underdiagnosed.
"Particular effectiveness of this method was demonstrated in the diagnosis of melanocytic lesions, skin cancers and melanomas, as well as in clinical differentiation between benign skin lesions and those suspected of malignant transformation . The application of dermatoscopy to diagnose oral mucosal melanocytic lesions has been reported [11–14]. This method was shown to be particularly effective in the estimation of the borders of pathologic lesions . "
[Show abstract][Hide abstract] ABSTRACT: Direct oral microscopy constitutes a novel technique of in vivo oral mucosae examination. The basic principles of this method derive from colposcopy and dermoscopy. The main goal of direct oral microscopy is the earliest possible detection of oral precancerous lesions in order to implement their treatment as quickly as possible and prevent malignant transformation.
To establish a standard picture of healthy oral mucosae with direct oral microscopy applying standard colposcopic criteria in order to create a reference point for further diagnosis of precancerous lesions.
Thirty patients of both genders with clinically unaltered oral mucosae were examined. For every individual, clinical examination with the naked eye was performed, followed by direct oral microscopy with colposcopic assessment criteria. Oral mucosae at various sites (lip, cheek, floor of mouth, ventral and lateral sides of the tongue, alveolar ridge and soft palate) were examined.
Subepithelial blood vessel patterns, mucosal surface, colour tone and transparency were described for healthy oral mucosae. Moreover, cases with clinically unaltered oral mucosae where direct oral microscopy revealed subclinical alterations were described.
Direct oral microscopy with colposcopic assessment criteria enables establishment of a repeated picture of unaltered oral mucosae. The standard picture of healthy oral mucosae is an essential reference point for application of this technique to early diagnose potentially malignant oral mucosal lesions as well as apply their early treatment.
[Show abstract][Hide abstract] ABSTRACT: Laugier-Hunziker syndrome is a rare acquired disorder characterized by diffuse hyperpigmentation of the oral mucosa and longitudinal melanonychia in adults. They appear as macular lesions less than 5 mm in diameter. Laugier-Hunziker syndrome is considered to be a benign disease with no systemic manifestation or malignant potential. Therefore, it is important to rule out other mucocutaneous pigmentary disorders that do require medical management. Prompt clinical recognition also averts the need for excessive and invasive procedures and treatments. In India, the reported cases of this syndrome are very few. We provide a review of literature on Laugier-Hunziker syndrome with its differential diagnosis.
Journal of Oral and Maxillofacial Pathology 05/2012; 16(2):245-50. DOI:10.4103/0973-029X.99079
[Show abstract][Hide abstract] ABSTRACT: Introspection leads us to believe that universals and meaning are extracted from sensory information before responsive action commences: as if we act first as passive observers whose subsequent reactions follow a process of recognition and decision. We are inclined to base our designs of cognitive systems upon such subjective insights. However, if we take into account the necessity for a prior, ontogenetic growth of a repertoire of perception, it appears more probable that we are engaged in unceasing interaction with our environment and that a response itself, driven by homeostatic mechanisms, contains the meaningful information about the object of the response. The components of the world are thereby described not in terms of their intrinsic spatio-temporal parameters but by their relation to the observer. A rudimentary visual system employing a Probability State Variable (PSV) Controller as a, homeostat is described, and the prototype peripheral hardware suggested. The addition of an associative memory would allow the buildup of a cognitive model of the world, but the reactive searching by the system described --- as if it were an autonomous "perceptuo-postural" mechanism --- must begin the process of discovering the properties of reality.
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