Pigments and color changes
Colour changes in and around the oral cavity are very frequent and occur in a large variety. Accordingly a correct diagnosis is often not easy to find. Therefore, it is important to obtain a careful anamnesis and a detailed documentation of the lesion. The anamnesis should include family history, smoking or other habits, change in pattern, drugs use, onset and duration of the noticed colour change.
Attention must be paid on location, colour and distribution of the pigmentation as well as the pigmentations on the facial skin, especially the perioral area and the lips should be observed. In addition, the presence of systemic coexisting symptoms should be examined. Although anamnesis and clinical findings may be a help in finding the aetiology of the colour change, a definitive diagnosis requires almost exclusively a histopathologic evaluation. Also diascopy, radiography and laboratory investigations like blood tests can be of help to reach a definitive diagnosis. In this chapter, the different pigmentations are divided into "exogenous" / "endogenous" pigmentations and "other colour changes" due to their aetiology.