MELANOSIS DEL FUMADOR. REPORTE DE UN CASO

Abstract

Los efectos del cigarrillo sobre la salud oral son variados. Una de las consecuencias de este habito son lesiones en la mucosa oral, que comprenden desde problemas esteticos hasta afecciones que podrian generar problemas de salud graves. La melanosis del fumador es una pigmentacion benigna de la mucosa oral predominantemente observada en la encia adherida y no asociada a factores geneticos, enfermedad o medicamentos terapeuticos, representa un problema dado que existe gran numero de fumadores con pigmentaciones sin etiologia clara. Con el objetivo de protocolizar el procedimiento diagnostico, se procedio a describir un caso clinico de un paciente masculino de 30 anos, que fue evaluado en la CIA de la Facultad de Odontologia de la ULA por presentar “manchas oscuras en la encia”. Al evaluar al paciente, se identificaron manchas en la encia adherida de ambos maxilares, de aproximadamente 8 anos de evolucion, se incrementaron en tamano de manera poco importante pero si en color, notando un pequeno oscurecimiento. Al examen clinico, se encontro: paciente de piel triguena, braquiocefalico, sin lesiones aparentes en cara y cuello, con queilitis leve en labios, hiperqueratinizacion en linea alba, pigmentaciones oscuras y lengua mediana. Periodontalmente, se observo: encia rosada, biotipo II, de consistencia y festoneado normales, con textura lisa en el sector posterior y puntillado en sector anterior. Como resultado, se puede afirmar que mediante la historia clinica se realizo correctamente un diagnostico de melanosis del fumador y diferencio de otras patologias. Se concluyo que la melanosis del fumador, es una alteracion en melanocitos de la capa basal del epitelio, asociada a tabaquismo prolongado y la importancia de realizar un diagnostico correcto radica en el hecho de que se puede diferenciar de otras pigmentaciones presentes en boca, aplicar un correcto tratamiento al momento en que se desean eliminar y prevenir la aparicion de lesiones malignas. DeCS: melanosis, fumador, lesion premaligna. Abstract Smoker’s melanosis. A case report The effects of smoking on oral health are varied, among the consequence of this habit are lesions in the oral mucosa, ranging from esthetic problems to conditions that may generate serious consequences. The smoker's melanosis is a benign pigmentation of the oral mucosa mainly observed in the attached gingiva and it is not associated to genetic factors, diseases or therapeutic drugs; it represents a problem because there is a large amount of smokers with pigmentations without a clear etiology. Aiming to establish a protocol for the diagnostic procedure, the authors proceeded to describe a clinical case of a 30-years male patient, which was assessed at the Adult Integral Clinic at the Faculty of Dentistry of the ULA for having spots in the gingival”. At the clinical evaluation spots in the attached gingiva of both jaws were identified, they were about 8 years of evolution, the spots grew a little in size, but in relation to the color a slight darkening was observed. At clinical examination it was observed: braqieocephalic tan skin patient without apparent injuries on face and neck, with slight lip cheilitis, hyperkeratynization in linea alba, medium size tongue and dark pigmentations. Pink gingiva, biotype II, normal consistency and scalloped shape with a smooth texture in the posterior and anterior on tiptoe were found. As a result, it is possible to affirm that through the clinical history a diagnosis of smoker’s melanosis was correctly performed and the lesion was differentiated from other pathologies. It was concluded that the smoker's melanosis, is an alteration of melanocytes from the basal layer of the epithelium, associated to prolonged smoking habits. The importance of making a proper diagnosis lies on the fact that it make possible to differentiate from other pigmentations observed in the mouth; a right treatment should be prescribed when it is expected to prevent or eliminate the presence of malign lesions. MeSH: melanosis, smoker, premalign lesion