[Congenital melanotic macules of the tongue]

Congenital oral and labial melanotic macules are the leading causes of hyperpigmented lesions of the oral mucosa in adults. Although they usually appear in the second decade of life, there are rare reports of these phenomena in children. Congenital lingual melanotic macules have been recently identified as a peculiar and benign cause of hyperpigmentation of the tongue in newborn babies and infants.

We describe the cases of five infants presenting with smooth brown macules of the dorsum of the tongue, measuring several millimetres and detected either at birth or a few days after birth. No history of trauma, medication or similar lesions in relatives was found. Surgical excision of the lesions was performed in two cases. Clinical follow-up in the three other children showed no changes in the lesions in the first two and lightening of the brown macules in the third.

Congenital lingual melanotic macules represent a clinically distinct and benign cause of hyperpigmentation of the oral mucosa. They may be more common than the literature suggests, especially among dark-skinned subjects.