24.45歲男性因下唇黑色斑塊求診，臨床所見如附圖一，切片檢查如附圖二，其正確診斷為下列何者？

(A)黑斑（melanotic macule）
(B)接合痣（junctional nevus）
(C)藍痣（blue nevus）
(D)黑色素瘤（melanoma）

nevus:  排列混亂，分三種

melanotic macule: increased melanin pigmentation distributed along basal epithelial layer. 排列整齊

oral melanoacanthoma: acanthosis 、 Spongiosis (intercellular spaces between the keratinocytes)

numerous dendritic melanocytes extending between the spinous epithelial cells.

Blue nevus:  spindle-shaped melanocytes located relatively deep within the lamina

propria and parallel to the surface epithelium.

Oral melanotic macule

- 與陽光曝曬無關
- 與
1) Peutz-Jeghers syndrome
2) McCune-Albright syndrome
3) Addison disease
4) Neurofibromatosis Type I
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