Table 1.

Clinicopathologic conditions associated with pigmentation of the nasal mucosa

Pigment	Histologic features	Localized	Generalized
Hemosiderina	Granular/crystalline, refractile golden to yellow–brown; positive with Perls’s stain	Gross or minute hemorrhages	Hemochromatosis
Melanina	Finely granular, pale to dark brown; stained in black with Fontana-Masson and in black with Schmorl methods; bleached with potassium permanganate–oxalic acid or with hydrogen peroxide	Lentigo, nevi (comprising nevus of Ota), and melanoma	Addison’s disease; Peutz-Jegher’s disease
Lipofuscina	Finely granular, yellow–brown, intracytoplasmic (often perinuclear); PAS-positive; variably acid-fast	Aging-related change
Goldb	Relatively large and irregular round–oval black granules, mainly within macrophages; orange–red birefringence on polarized light	Not reported	Systemic drug therapy (usually intramuscular injections) with gold-containing compounds
Silverb	Small brown–black granules in a ‘band-like’ deposition; stained in reddish-brown with rhodamine on frozen sections	Occupational; topical silver-containing drugs	Systemic drug therapy with silver-containing compounds
Mercuryb	Very small, brown–black refractile particles within macrophages and around blood vessels	Exposure to mercury vapors	Systemic drug therapy with mercury-containing compounds; chronic poisoning (infantile acrodynia)
Bismuthb	Small carbon-like particles	Not reported	Systemic drug therapy with bismuth-containing compounds

^aEndogenous pigmentation

^bExogenous pigmentation