Amalgam Tattoo
(Focal argyrosis)
Clinical features
– Black or bluish-black (usually) solitary, nonelevated small pigmented area beneath normal mucosa; usually related to lower ridge or buccal vestibule; more rarely palate and floor of the mouth.
– It is asymptomatic and may rarely be radiopaque.
Incidence
– Common: mainly in adults.
Aetiology
– Amalgam particles or dust can become incorporated in healing wounds after tooth extraction or apicectomy or beneath mucosa (i.e. after an abrasion with a bur or elevator).
Diagnosis
– May need to excise to exclude melanoma microscopically.
– Differentiate from other causes of pigmentation, especially naevi and melanoma.
Management
– The lesions are of no clinical importance but excision biopsy may sometimes be necessary to distinguish reliably from naevus or melanoma, or for aesthetic reasons.
