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Keywords: focal hyperpigmentation, gingival enlargement, intramucosal, melanoma, nevi, oral Introduction Nevi are either congenital or acquired, benign, pigmented neoplasms of the skin or mucosa characterized by the presence of melanin-producing neuroectodermal-derived cells.1 Pigmented nevi in the oral cavity are distinctly uncommon and when present can occur anywhere in the oral cavity.2 King et al in a large-scale survey reported that oral pigmented nevi are a rare entity found only in 0.1% of the patients and coined a specific term, intramucosal nevus.3,4 The most common intraoral sites affected are the hard palate, buccal mucosa and gingiva

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Recognised causes of granulomas such as sarcoidosis and Crohns disease should be excluded with requisite serology and chest x-ray