Peutz-Jeghers syndrome, an inherited polyposis syndrome, typically presents during the first one to two years of life and is associated with hyperpigmented mucocutaneous macules.

Melanotic macules are the most common oral mucosal lesions of melanocytic origin. 3 These small, solitary, well-circumscribed and often uniformly pigmented lesions develop most commonly in adult female patients. Any mucosal site may be affected but the lower lip, gingiva and palate are the most common areas.

The answer is A: chemotherapy-induced hyperpigmentation, which appears as a painless rash that can occur over various regions of the body, including the hands, feet, and mucous membranes....

The oral hyperpigmented macules of Addison disease can be found diffusely on the tongue, gingiva, buccal mucosa, and hard palate. The macules tend to be blue-black or brown and can be spotty or streaked in the configuration.

A 3-week-old Hispanic male newborn was examined because of 6 hyperpigmented, dark-brown, circular lesions on the tongue that had first been noted at birth. The macules measured 3 to 4 mm and were located on the dorsal mid and anterior portion of the tongue.