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Nausea, fatigue, reduced appetite, and digestive changes are common

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It involves genetic disposition, environmental triggers, substance abuse and microbial factors

This chapter is set out as follows: History Clinical findings Images Management History Mucosal melanocytic macules are more common in women than men The age at onset is approximately 30 years Clinical findings Distribution The lips are the most common site, especially the central third of the lower lip Morphology Lesions present as brown-black macules, and are usually solitary - s everal lesions should increase the suspicion of a systemic condition such as Peutz-Jeghers syndrome, Addison's disease and multiple lentiginoses (eg the Leopard syndrome) Size - under 1 cm in diameter Once developed the lesions usually remain unchanged in size and colour Dermoscopic examination of oral and genital lesions Benign lesions - diffuse pigmentation with a peculiar parallel pattern of partially linear and partially curvilinear light-brown to dark-brown streaks Melanoma - the combination of blue, grey, or white colour with structureless zones are the strongest indicators of mucosal melanoma Clinical Images Please refer to notes on image rights at bottom of the page with regards to individual image ownership