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An oral melanotic macule appears as a brown or grayish-brown macule (a small flat, smooth area of skin or mucosa) usually less than 7 mm in diameter

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E2F activates the transcription of pro-S phase cell cycle genes, promoting G1/S phase transition ( In families without mutations in CDKN2A and CDK4 genes, the use of NGS methodologies has allowed the identification of rare germline mutations in a few novel melanoma susceptibility genes, namely BRCA1 Associated Protein 1 (BAP1), TERT , Protection of Telomeres 1 ( POT1 ), ACD Shelterin Complex Subunit and Telomerase Recruitment Factor ( ACD ), TERF2 Interacting Protein ( TERF2IP ) (high risk genes) and MC1R, MITF (low to moderate risk genes)

It can sometimes be confused with gingival hyperplasia.7 Irritant/frictional leukokeratosis A most frequent cause of oral white (or leukoplakia-like) lesions