The deposition of hemosiderin pigment in multiple organs and tissues occurs in a primary heritable disease with a prominent male predilection or may evolve secondary to a variety of diseases and conditions, including chronic anemia, porphyria, cirrhosis, postcaval shunt for portal hypertension, and excess intake of iron.The oral mucosal lesions of hemochromatosis are brown to gray diffuse macules that tend to occur in the palate and gingiva.
Although these pigmentations are predominantly the result of iron deposition in the submucosa, basilar melanosis is also observed microscopically and may be the result of a secondary addisonian complication, whereby hemosiderin deposition within the adrenal cortex may lead to hypocorticism and ACTH hypersecretion.When hemochromatosis is suspected, an oral biopsy may be helpful in the diagnosis. The tissue can be stained for iron by using Prussian blue; iron levels will be elevated in the serum if hemochromatosis is present. Since the condition can be the consequence of a variety of disease states, medical referral is recommended.