Pigmented entities are relatively common in the oral mucosa and arise from intrinsic and extrinsic sources. Conditions such as melanotic macules, nevi, smoker’s melanosis, amalgam and graphite tattoos, racial pigmentation, and vascular blood-related pigments occur with some frequency. Addison disease and Peutz-Jeghers syndrome also appear in perioral and oral locations as pigmented macules.

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