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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Fungiform papillae of the tongue are small projections involved in taste function that are typically located on the lateral aspects and tip of the tongue&#46; They are called <span class="elsevierStyleItalic">fungiform papillae</span> because of their close resemblance to a fungus&#46; In fair-skinned individuals&#44; they are usually pink or red&#44; but in dark-skinned individuals&#44; they are frequently pigmented and are considered a variant of normal oral pigmentation&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a> We report a case of pigmented fungiform papillae of the tongue &#40;PFPT&#41; and describe its dermoscopic features&#44; which have been rarely reported in the literature&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 30-year-old black woman with no personal or family history of interest was evaluated for a pigmented lesion with no apparent cause on the tongue&#46; The lesion had appeared in adolescence but had remained stable and asymptomatic &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The patient was not taking any regular medication&#44; did not smoke&#44; had not had dental treatment in the area of the papillae&#44; and had adequate oral hygiene&#46; The rest of the physical examination was unremarkable&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Dermoscopy showed several projections with hyperpigmented edges whose surfaces contained vessels that emerged from the base forming successive branches resembling rose petals&#46; This rose petal pattern was previously described by Mukamal et al&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a> in PFPT &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Another report of the dermoscopic features of PFPT referred to a cobblestone or cobblestone-like pattern&#44;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">3</span></a> but we believe that this is less accurate as the lesion is not a nevus&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">PFPL are located on the tip&#44; dorsum&#44; and&#47;or lateral aspects of the tongue&#44; and are distributed among filiform papillae&#46; They are typically red or pink&#44; although a brown variant has been reported&#46; Most cases of PFPT in the literature have been described in Afro-American patients&#44; suggesting that black individuals are more susceptible to this condition than other races&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a> The pigmentation is limited to the fungiform papillae&#44; and lesions usually appear in childhood&#44; do not progress&#44; and remain asymptomatic&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The differential diagnosis should include other pigmented lesions of the oral mucosa&#44; such as those seen in hemochromatosis&#44; pernicious anemia&#44; amalgam tattoo&#44; and Addison disease&#46; In all cases&#44; however&#44; a clear diagnosis can be established based on either the clinical features and distribution of the lesions or the accompanying manifestations&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">4</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The pathogenesis of PFPT is unknown&#44; and it is also unclear why only the fungiform papillae are affected&#59; treatment is not necessary due to the benign nature of the condition&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">4</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Histologic examination may or may not reveal pigmentation of basal keratinocytes with abundant melanophages in the lamina propria&#59; this finding corresponds to the pigmented structures seen in dermoscopy&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">1&#44;3</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Although dermoscopy is now widely used in clinical practice&#44; few studies have described the dermoscopic features of pigmented oral lesions&#44; and most reports have focused on vulvar lesions&#46; Several characteristic dermoscopic patterns have been described for oral mucosal lesions&#44; and they can all occur in either benign or malignant lesions&#46; Benign lesions can have one pattern or several patterns &#40;in up to 56&#37; of cases&#41; with a regular distribution&#44; while melanomas tend to have several patterns&#44; which in addition are irregularly distributed&#46; The main patterns described to date are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">5&#44;6</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">The most common patterns in benign pigmented mucosal lesions are globular &#40;25&#37;&#41;&#44; homogeneous &#40;25&#37;&#41;&#44; fish scale-like &#40;18&#46;8&#37;&#41;&#44; and hyphal &#40;18&#46;8&#37;&#41;&#44; while in mucosal melanoma lesions they are the multicomponent pattern &#40;75&#37;&#41; and the homogeneous pattern &#40;25&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">7</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Just one other study to date has described the rose petal pattern observed in our patient as a typical dermoscopic feature of PFPL&#44; and the authors suggested that its presence&#44; in the absence of other alterations&#44; might rule out malignancy&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">We found a close resemblance between the rose petal structure seen in PFPT and the ring-like pattern seen in pigmented melanocytic mucosal lesions&#46; We thus propose that the rose petal pattern should be considered a subtype of the ring-like pattern&#44; as there is also histologic overlapping&#44; with both entities containing pigment deposits in the stroma&#46;</p></span>"
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                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Parallel pattern&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Linear distribution of pigment in the form of hyphae&#44; globules&#44; or fingerprint-like structures&#46; Commonly seen in small lesions and particularly in melanocytic macules&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Ring-like pattern&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Globular pattern&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Multicomponent pattern&#40;polymorphous&#41;&nbsp;\t\t\t\t\t\t\n
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Case and Research Letters
Dermoscopic Features of Pigmented Fungiform Papillae of the Tongue
Características dermatoscópicas de las papilas fungiformes pigmentadas de la lengua
V. Pinos-Leóna,b
a Servicio de Dermatología, Hospital San Francisco de Quito, Quito, Ecuador
b Postgrado de Dermatología, Universidad Central del Ecuador, Quito, Ecuador
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      "titulo" => "Usefulness of High-Frequency Ultrasound in the Diagnosis of Piezogenic Pedal Papules"
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    "titulo" => "Dermoscopic Features of Pigmented Fungiform Papillae of the Tongue"
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        "titulo" => "Caracter&#237;sticas dermatosc&#243;picas de las papilas fungiformes pigmentadas de la lengua"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Fungiform papillae of the tongue are small projections involved in taste function that are typically located on the lateral aspects and tip of the tongue&#46; They are called <span class="elsevierStyleItalic">fungiform papillae</span> because of their close resemblance to a fungus&#46; In fair-skinned individuals&#44; they are usually pink or red&#44; but in dark-skinned individuals&#44; they are frequently pigmented and are considered a variant of normal oral pigmentation&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a> We report a case of pigmented fungiform papillae of the tongue &#40;PFPT&#41; and describe its dermoscopic features&#44; which have been rarely reported in the literature&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 30-year-old black woman with no personal or family history of interest was evaluated for a pigmented lesion with no apparent cause on the tongue&#46; The lesion had appeared in adolescence but had remained stable and asymptomatic &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The patient was not taking any regular medication&#44; did not smoke&#44; had not had dental treatment in the area of the papillae&#44; and had adequate oral hygiene&#46; The rest of the physical examination was unremarkable&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Dermoscopy showed several projections with hyperpigmented edges whose surfaces contained vessels that emerged from the base forming successive branches resembling rose petals&#46; This rose petal pattern was previously described by Mukamal et al&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a> in PFPT &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Another report of the dermoscopic features of PFPT referred to a cobblestone or cobblestone-like pattern&#44;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">3</span></a> but we believe that this is less accurate as the lesion is not a nevus&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">PFPL are located on the tip&#44; dorsum&#44; and&#47;or lateral aspects of the tongue&#44; and are distributed among filiform papillae&#46; They are typically red or pink&#44; although a brown variant has been reported&#46; Most cases of PFPT in the literature have been described in Afro-American patients&#44; suggesting that black individuals are more susceptible to this condition than other races&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a> The pigmentation is limited to the fungiform papillae&#44; and lesions usually appear in childhood&#44; do not progress&#44; and remain asymptomatic&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The differential diagnosis should include other pigmented lesions of the oral mucosa&#44; such as those seen in hemochromatosis&#44; pernicious anemia&#44; amalgam tattoo&#44; and Addison disease&#46; In all cases&#44; however&#44; a clear diagnosis can be established based on either the clinical features and distribution of the lesions or the accompanying manifestations&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">4</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The pathogenesis of PFPT is unknown&#44; and it is also unclear why only the fungiform papillae are affected&#59; treatment is not necessary due to the benign nature of the condition&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">4</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Histologic examination may or may not reveal pigmentation of basal keratinocytes with abundant melanophages in the lamina propria&#59; this finding corresponds to the pigmented structures seen in dermoscopy&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">1&#44;3</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Although dermoscopy is now widely used in clinical practice&#44; few studies have described the dermoscopic features of pigmented oral lesions&#44; and most reports have focused on vulvar lesions&#46; Several characteristic dermoscopic patterns have been described for oral mucosal lesions&#44; and they can all occur in either benign or malignant lesions&#46; Benign lesions can have one pattern or several patterns &#40;in up to 56&#37; of cases&#41; with a regular distribution&#44; while melanomas tend to have several patterns&#44; which in addition are irregularly distributed&#46; The main patterns described to date are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">5&#44;6</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">The most common patterns in benign pigmented mucosal lesions are globular &#40;25&#37;&#41;&#44; homogeneous &#40;25&#37;&#41;&#44; fish scale-like &#40;18&#46;8&#37;&#41;&#44; and hyphal &#40;18&#46;8&#37;&#41;&#44; while in mucosal melanoma lesions they are the multicomponent pattern &#40;75&#37;&#41; and the homogeneous pattern &#40;25&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">7</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Just one other study to date has described the rose petal pattern observed in our patient as a typical dermoscopic feature of PFPL&#44; and the authors suggested that its presence&#44; in the absence of other alterations&#44; might rule out malignancy&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">We found a close resemblance between the rose petal structure seen in PFPT and the ring-like pattern seen in pigmented melanocytic mucosal lesions&#46; We thus propose that the rose petal pattern should be considered a subtype of the ring-like pattern&#44; as there is also histologic overlapping&#44; with both entities containing pigment deposits in the stroma&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Pinos-Le&#243;n V&#46; Caracter&#237;sticas dermatosc&#243;picas de las papilas fungiformes pigmentadas de la lengua&#46; Actas Dermosifiliogr&#46; 2015&#59;106&#58;593&#8211;594&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Parallel pattern&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Linear distribution of pigment in the form of hyphae&#44; globules&#44; or fingerprint-like structures&#46; Commonly seen in small lesions and particularly in melanocytic macules&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Ring-like pattern&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Brown circles with borders that are darker than the surrounding area&#46; When the ring is incomplete&#44; the pattern is referred to as fish scale-like&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Homogenous pattern&#40;no structures&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Diffuse light brown&#44; dark brown&#44; or black pigmentation&#46; Frequently seen in larger lesions&#46; The additional presence of blue&#44; gray&#44; or white colors suggests melanoma&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Globular pattern&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Regularly or irregularly distributed dots or globules&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Reticular pattern&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Network or honeycomb structure&#46; This pattern is rarely seen in true mucosal areas&#44; as these have a flat dermal-epidermal junction and no crests or papillae are seen&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Multicomponent pattern&#40;polymorphous&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mix of 3 or more irregularly distributed patterns &#40;most often&#44; homogeneous&#44; reticular&#44; and globular&#41;&#46; Almost exclusively seen in melanoma&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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Información del artículo
ISSN: 15782190
Idioma original: Inglés
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