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The clinician should also determine the onset and duration of the lesion, the presence of systemic signs and symptoms, drug use and smoking habits as well as the number, distribution, size, shape and colour of the pigmentation

Melanocytes can also function as neuroendocrine cells by producing acetylcholine, catecholamines, and POMC-derived peptides, which have the capacity to mediate local immunoinflammatory and antimicrobial responses and to modulate the biological behaviour of oral tissues [4]