Brief Answer: Need more information Detailed Answer: Hello and welcome to healthcaremagic I would like to gather some more information from you in order to be able to help you better. -Does the pigmentation affect the whole of your lip or only some part of it? -Do you have sensitivity to spicy food? -Did it appear suddenly OR gradually? -Did it appear after taking some oral medications/drugs like antibiotics, pain killers etc? -Do you notice discoloration at other body sites like dorsal hands and feet, periungual discoloration, nail discoloration? -If possible upload a clear picture of the area of concern? I would keep a possibility of Oral Lichen Planus Or Addisonian hyperpigmentation OR Fixed Drug Eruption. In Lichen planus there is bluish blackish discoloration of the oral mucosa (buccal and labial mucosa). There may also be skin lesions on arms, abdomen and legs which are characteristically itchy. However Lichen planus may present with just oral mucosal involvement. There might be erosive lesions as well in the oral mucosa which can cause sensitivity to spicy food. In Addisonian hyperpigmentation brown-black discoloration is noted at various body sites: Involvement of face, oral mucosa, dorsal hands and feet with periungual accentuation is characteristic. Nail discoloration is also noted. Vit B12 deficiency has been reported as one of the causes of addisonian hyperpigmentation, in otherwise healthy individuals. Vegetarians are at a higher risk for developing this deficiency because animal products are the main sources of vitamin B12. The hyperpigmentation is reversible with replacement of vitamin B12 levels. An oral Vit B12 supplement in a dose of 500 mcg daily would help in case the reason is addisonian hyperpigmentation. If i was your treating doctor i would have also asked you to apply a moderately potent topical steroid like mometasone once or twice daily which would help in fading away the discoloration gradually. regards

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Brief Answer: Lichen palnus Detailed Answer: Hi. Thanks for the additional information. Suggests me a possibility of Lichen Planus. Lichen planus of the lip is a well known entity. Clinically presents as bluish pigmentation of the labial mucosa. Erosions and crusting may also be present. It can be associated with involvement of the buccal mucosa as well, but can occur as an isolated entity. Treatment is with topical steroid e.g mometasone furoate cream twice daily. A popular brand marketed by Ranbaxy in India, 'Cutizone cream' contains mometasone furoate. It can be used twice daily at the affected site. regards

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