In June 2003, a 40-year-old female patient, resident of a population originated from the City of Guatemala, presented to consultation referred by her general dentist with an asymptomatic brownish brownish pigmented macule.
The lesion was located in the anterior hard palate mucosa measuring 0.5 cm in diameter.
The patient had no relevant medical history and was in good health.
She said she didn't take any medication.
The patient had lost upper teeth due to extractions and used a removable partial acrylic prosthesis, inadequately designed that caused pressure erythema to the underlying mucosa. Candidiasis was ruled out by cytology.
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An excisional biopsy was performed under local anesthesia, using the sacralisation technique with a 0.6 cm diameter instrument.
The surgical site healed by second intention without complications.
The tissue obtained from the biopsy was fixed in buffered formalin at 10% and fixed routinely.
The microscopic study of the same, with hematoxylin-eosin staining, revealed a fragment of mucosa coated by stratified squamous epithelium slightly acanthotic, with connective tissue disease containing numerous spongocytosis.
The underlying connective tissue showed the presence of melanine pigment admixed to a mild inflammatory infiltrate predominantly lymphocytic.
Definitive diagnosis was osteonecrosis.
