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Pigmentation, Heavy Metals

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Encyclopedia of Pathology

Part of the book series: Encyclopedia of Pathology ((EP))

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Definition

Exposure to or ingestion of heavy metals can lead to pigmentation of the oral mucosa, caused by peripheral metal accumulation (Joska et al. 2009). The exposure may be massive or minimal over a longer period. Ingestion of lead (lead-contaminated water or paint or inhalation of fumes produced by burning storage batteries), mercury (teething powders, cathartic agents, anthelmintic preparations), silver (topical silver nitrate), bismuth (treatment of venereal diseases in the past), arsenic (treatment of asthma and skin disorders in the past), and gold (treatment of rheumatoid arthritis) is rare, but may lead to oral pigmentation just as excessive zinc, iron, tin, and manganese (ten Bruggenkate et al. 1975; Wadhera and Fung 2005; Zala et al. 1993). Bismuth is associated with diffuse oral pigmentation and formation of a blue-black line at the marginal gingiva. Plumbism (lead poisoning) presents with a gray linear area of discoloration below the marginal gingiva (Burton’s line)....

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References and Further Reading

  • Joska, L., Venclikova, Z., Poddana, M., & Benada, O. (2009). The mechanism of gingiva metallic pigmentations formation. Clinical Oral Investigations, 13, 1–7.

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  • Meleti, M., Vescovi, P., Mooi, W. J., & van der Waal, I. (2008). Pigmented lesions of the oral mucosa and perioral tissues: A flow/chart for the diagnosis and some recommendations for the management. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 105, 606–616.

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  • ten Bruggenkate, C. M., Lopes, C. E., Maaskant, P., & van der Waal, I. (1975). Lead poisoning with pigmentation of the oral mucosa. Oral Surgery, Oral Medicine, and Oral Pathology, 39, 747–753.

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  • Wadhera, A., & Fung, M. (2005). Systemic argyria associated with ingestion of colloidal silver. Dermatology Online Journal, 11, 12.

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  • Zala, L., Hunziker, T., & Braathen, L. R. (1993). Pigmentation following long-term bismuth therapy for pneumatosis cystoides intestinalis. Dermatology, 187, 288–289.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pathology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands

    Jacqueline E. van der Wal

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  1. Jacqueline E. van der Wal
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Correspondence to Jacqueline E. van der Wal .

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Editors and Affiliations

  1. NIJMEGEN, The Netherlands

    J.H.J.M. van Krieken

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van der Wal, J.E. (2018). Pigmentation, Heavy Metals. In: van Krieken, J. (eds) Encyclopedia of Pathology. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-28845-1_766-1

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  • DOI: https://doi.org/10.1007/978-3-319-28845-1_766-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-28845-1

  • Online ISBN: 978-3-319-28845-1

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