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Pigmented Fungiform Papillae of the Tongue in Laugier Disease (or Laugier-Hunziker Syndrome)
Pigmentación de las papilas fungiformes linguales en la enfermedad de Laugier (o síndrome de Laugier-Hunziker)
Dermatologists in private practice, Santiago de Chile, Chile
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Hematoxylin-eosin, original magnification ×40.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.C. Montis-Palos, E. Acebo-Mariñas, B. Catón-Santarén, R. Soloeta-Arechavala" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M.C." "apellidos" => "Montis-Palos" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Acebo-Mariñas" ] 2 => array:2 [ "nombre" => "B." "apellidos" => "Catón-Santarén" ] 3 => array:2 [ "nombre" => "R." "apellidos" => "Soloeta-Arechavala" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731012003006" "doi" => "10.1016/j.ad.2012.02.017" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731012003006?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219013000139?idApp=UINPBA000044" "url" => "/15782190/0000010400000002/v1_201304241618/S1578219013000139/v1_201304241618/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Pigmented Fungiform Papillae of the Tongue in Laugier Disease (or Laugier-Hunziker Syndrome)" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "173" "paginaFinal" => "174" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "F. Urbina, E. Sudy" "autores" => array:2 [ 0 => array:4 [ "nombre" => "F." "apellidos" => "Urbina" "email" => array:1 [ 0 => "fcourbina@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Sudy" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Dermatologists in private practice, Santiago de Chile, Chile" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pigmentación de las papilas fungiformes linguales en la enfermedad de Laugier (o síndrome de Laugier-Hunziker)" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with interest the case and research letter by Marcoval et al.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> regarding 2 cases of pigmented fungiform papillae of the tongue. We were surprised that the letter did not mention Laugier disease (or Laugier-Hunziker syndrome), an entity characterized by essential cutaneous and mucosal pigmentation, originally described on the lips and oral mucosa and, at times, associated with longitudinal melanonychia.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In 1998, we reported 9 cases of Laugier disease, in 1 man and 8 women.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Two of the women presented punctate pigmentation of the tongue identical to the cases reported by Marcoval et al.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> One of these patients also had hyperpigmented lesions affecting the oral mucosa, gums, labia menora, and nails. The other presented pigmentation of the lips, gums, oral mucosa, and lateral nail folds on some fingers.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We have found reports of other similar cases described as Laugier-Hunziker syndrome; these patients presented punctate pigmentation of the lingual papillae as described by Marcoval et al.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> in association with pigmentation of the nails,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> the lower lip and the toes and fingers,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> and in one case the oral mucosa, the lips, and the nails.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> We believe that all of these case reports, including that of Marcoval et al.,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> correspond to the same process—hyperpigmentation of unknown etiology affecting the lips, oral mucosa, tongue (fungiform papillae), nails, genitals, and perhaps other areas in a variety of ways, in combination or alone.</p><p id="par0020" class="elsevierStylePara elsevierViewall">After we reported our series as Laugier disease, we were criticized for omitting Hunziker from the eponymous name.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Our use of the term <span class="elsevierStyleItalic">Laugier disease</span> followed the example of French authors, who preferred this name to that of <span class="elsevierStyleItalic">idiopathic pigmentation of the mucosa</span>, a term that does not include the involvement of the nails. Another reason for our choice was that, in several published reports, the process was considered to be Laugier-Hunziker syndrome only when pigmentation of the oral mucosa was associated with longitudinal melanonychia, a distinction that gave rise to some confusion.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In response to the criticism, we put forward our view of what the process should be called when new reports appeared of combined involvement of the oral mucosa and the nails, and in the case of similar lesions affecting the genitals, conjunctiva, larynx, or esophagus as well as other combinations of pigmentation and even isolated lesions affecting only the nails or only a mucosal membrane.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Shortly thereafter, in line with our reasoning concerning variations of the earlier descriptions, a report was published of a case involving the oral mucosa, lip, palate, palm, and esophagus in which the authors referred to the process as Laugier-Hunziker syndrome associated with esophageal melanocytosis.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> This was the first description of such a combination. Histologic study of biopsy specimens showed acanthosis and basal pigmentation in the esophagus, on the lip and on the palms. Three years earlier, a case had been reported of a patient with pigmented lesions on the lips and oral mucosa associated with pigmentation of several fingers, the eyebrows, and the heels. The title of that article described the case as Laugier-Hunziker syndrome with atypical features and the authors reported that they had considered the possibility of Peutz-Jeghers syndrome, albeit incomplete because of the absence of intestinal polyposis.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In summary, several different idiopathic pigmentation disorders of the skin, nails, oral mucosa, and genitals exist, and a variety of names have been used to denominate them. Because of the large number of names used, all probably referring to the same entity, we approve of the proposal by Seoane et al.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> that this condition be called <span class="elsevierStyleItalic">essential mucocutaneous hyperpigmentation.</span> However, as this term encompasses the idea of concurrent involvement of the skin and mucous membranes, which—as we have shown—is extremely variable, we consider that the designation should be <span class="elsevierStyleItalic">essential cutaneous and/or mucosal hyperpigmentation</span> or even <span class="elsevierStyleItalic">essential melanin pigmentation of the skin, mucous membranes, or nails</span>. This last designation reflects the melanocytic origin of the condition and the variable involvement in a more detailed and well-defined way; it could also be rendered simply as <span class="elsevierStyleItalic">essential melanin pigmentation</span> (of Laugier-Hunziker if you will), a name that would do justice to the initial description.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The condition is not as rare as it was thought and we believe that its incidence is influenced by a certain racial predisposition in which some unknown factor triggers the appearance of lesions by way of an increase in the synthesis of melanosomes, with idiosyncratic involvement of a variety of sites which, for unknown reasons, are more susceptible to this condition and vary from case to case.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The principal histologic features are hyperpigmentation of the basal layer without increased melanocytes, associated with acanthosis and the presence of melanophages, and a variable chronic inflammatory infiltrate in the dermis.</p><p id="par0045" class="elsevierStylePara elsevierViewall">As this is not a disease or a syndrome, to facilitate naming the entity, some form of eponym will probably come to predominate over the long term.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Urbina F, Sudy E. Pigmentación de las papilas fungiformes linguales en la enfermedad de Laugier (o síndrome de Laugier-Hunziker). Actas Dermosifiliogr. 2013;104:173-4.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pigmentación de las papilas fungiformes linguales. A propósito de dos casos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Marcoval" 1 => "J. Notario" 2 => "S. Martín-Sala" 3 => "I. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 15 | 10 | 25 |
| 2024 Octubre | 76 | 40 | 116 |
| 2024 Septiembre | 89 | 25 | 114 |
| 2024 Agosto | 103 | 59 | 162 |
| 2024 Julio | 86 | 37 | 123 |
| 2024 Junio | 97 | 28 | 125 |
| 2024 Mayo | 61 | 37 | 98 |
| 2024 Abril | 64 | 20 | 84 |
| 2024 Marzo | 64 | 31 | 95 |
| 2024 Febrero | 40 | 29 | 69 |
| 2024 Enero | 38 | 35 | 73 |
| 2023 Diciembre | 53 | 18 | 71 |
| 2023 Noviembre | 59 | 31 | 90 |
| 2023 Octubre | 63 | 22 | 85 |
| 2023 Septiembre | 65 | 22 | 87 |
| 2023 Agosto | 48 | 19 | 67 |
| 2023 Julio | 53 | 31 | 84 |
| 2023 Junio | 85 | 30 | 115 |
| 2023 Mayo | 67 | 28 | 95 |
| 2023 Abril | 40 | 27 | 67 |
| 2023 Marzo | 43 | 39 | 82 |
| 2023 Febrero | 37 | 15 | 52 |
| 2023 Enero | 35 | 33 | 68 |
| 2022 Diciembre | 47 | 33 | 80 |
| 2022 Noviembre | 23 | 23 | 46 |
| 2022 Octubre | 26 | 32 | 58 |
| 2022 Septiembre | 17 | 32 | 49 |
| 2022 Agosto | 24 | 26 | 50 |
| 2022 Julio | 23 | 39 | 62 |
| 2022 Junio | 26 | 30 | 56 |
| 2022 Mayo | 36 | 39 | 75 |
| 2022 Abril | 39 | 22 | 61 |
| 2022 Marzo | 41 | 41 | 82 |
| 2022 Febrero | 36 | 31 | 67 |
| 2022 Enero | 21 | 31 | 52 |
| 2021 Diciembre | 25 | 48 | 73 |
| 2021 Noviembre | 38 | 49 | 87 |
| 2021 Octubre | 34 | 42 | 76 |
| 2021 Septiembre | 35 | 40 | 75 |
| 2021 Agosto | 39 | 35 | 74 |
| 2021 Julio | 40 | 29 | 69 |
| 2021 Junio | 29 | 25 | 54 |
| 2021 Mayo | 43 | 31 | 74 |
| 2021 Abril | 95 | 65 | 160 |
| 2021 Marzo | 70 | 25 | 95 |
| 2021 Febrero | 83 | 22 | 105 |
| 2021 Enero | 58 | 28 | 86 |
| 2020 Diciembre | 26 | 21 | 47 |
| 2020 Noviembre | 35 | 18 | 53 |
| 2020 Octubre | 34 | 8 | 42 |
| 2020 Septiembre | 35 | 4 | 39 |
| 2020 Agosto | 45 | 24 | 69 |
| 2020 Julio | 26 | 9 | 35 |
| 2020 Junio | 46 | 25 | 71 |
| 2020 Mayo | 36 | 16 | 52 |
| 2020 Abril | 27 | 32 | 59 |
| 2020 Marzo | 35 | 21 | 56 |
| 2020 Febrero | 9 | 10 | 19 |
| 2020 Enero | 0 | 7 | 7 |
| 2019 Diciembre | 4 | 0 | 4 |
| 2019 Septiembre | 4 | 0 | 4 |
| 2019 Julio | 0 | 9 | 9 |
| 2019 Junio | 2 | 12 | 14 |
| 2019 Mayo | 1 | 27 | 28 |
| 2019 Abril | 0 | 6 | 6 |
| 2019 Marzo | 2 | 8 | 10 |
| 2019 Febrero | 0 | 4 | 4 |
| 2019 Enero | 1 | 0 | 1 |
| 2018 Diciembre | 3 | 2 | 5 |
| 2018 Noviembre | 2 | 0 | 2 |
| 2018 Octubre | 2 | 2 | 4 |
| 2018 Septiembre | 2 | 0 | 2 |
| 2018 Marzo | 10 | 2 | 12 |
| 2018 Febrero | 27 | 4 | 31 |
| 2018 Enero | 28 | 5 | 33 |
| 2017 Diciembre | 22 | 6 | 28 |
| 2017 Noviembre | 33 | 8 | 41 |
| 2017 Octubre | 28 | 4 | 32 |
| 2017 Septiembre | 31 | 10 | 41 |
| 2017 Agosto | 57 | 22 | 79 |
| 2017 Julio | 66 | 9 | 75 |
| 2017 Junio | 36 | 27 | 63 |
| 2017 Mayo | 33 | 8 | 41 |
| 2017 Abril | 34 | 15 | 49 |
| 2017 Marzo | 20 | 24 | 44 |
| 2017 Febrero | 28 | 9 | 37 |
| 2017 Enero | 16 | 9 | 25 |
| 2016 Diciembre | 33 | 12 | 45 |
| 2016 Noviembre | 36 | 10 | 46 |
| 2016 Octubre | 47 | 26 | 73 |
| 2016 Septiembre | 46 | 17 | 63 |
| 2016 Agosto | 45 | 20 | 65 |
| 2016 Julio | 29 | 4 | 33 |
| 2016 Junio | 12 | 16 | 28 |
| 2016 Mayo | 6 | 10 | 16 |
| 2016 Abril | 3 | 3 | 6 |
| 2016 Marzo | 8 | 1 | 9 |
| 2016 Febrero | 4 | 12 | 16 |
| 2016 Enero | 8 | 1 | 9 |
| 2015 Diciembre | 13 | 3 | 16 |
| 2015 Noviembre | 16 | 9 | 25 |
| 2015 Octubre | 11 | 2 | 13 |
| 2015 Septiembre | 4 | 2 | 6 |
| 2015 Agosto | 9 | 4 | 13 |
| 2015 Julio | 51 | 13 | 64 |
| 2015 Junio | 52 | 7 | 59 |
| 2015 Mayo | 75 | 14 | 89 |
| 2015 Abril | 57 | 10 | 67 |
| 2015 Marzo | 50 | 9 | 59 |
| 2015 Febrero | 16 | 11 | 27 |
| 2015 Enero | 22 | 5 | 27 |
| 2014 Diciembre | 20 | 9 | 29 |
| 2014 Noviembre | 9 | 5 | 14 |
| 2014 Octubre | 27 | 3 | 30 |
| 2014 Septiembre | 10 | 6 | 16 |
| 2014 Agosto | 15 | 4 | 19 |
| 2014 Julio | 24 | 6 | 30 |
| 2014 Junio | 39 | 4 | 43 |
| 2014 Mayo | 28 | 8 | 36 |
| 2014 Abril | 31 | 6 | 37 |
| 2014 Marzo | 30 | 9 | 39 |
| 2014 Febrero | 18 | 10 | 28 |
| 2014 Enero | 24 | 9 | 33 |
| 2013 Diciembre | 33 | 7 | 40 |
| 2013 Noviembre | 15 | 6 | 21 |
| 2013 Octubre | 8 | 5 | 13 |
| 2013 Septiembre | 6 | 7 | 13 |
| 2013 Agosto | 3 | 10 | 13 |
| 2013 Julio | 5 | 23 | 28 |
| 2013 Junio | 4 | 21 | 25 |
| 2013 Mayo | 3 | 17 | 20 |
| 2013 Abril | 7 | 32 | 39 |
| 2013 Marzo | 9 | 7 | 16 |
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