Oral pigmentation in children: a diagnostic challenge Archives of Disease in Childhood Pigmented lesions of the oral mucosa and perioral tissues: a flow chart for the diagnosis and some recommendations for the management ScienceDirect Oral pigmentation in children: a diagnostic challenge Archives of Disease in Childhood A 9 year old boy presented for evaluation of dark spots on the tongue. The family first noted these spots 5 months prior and reported that they remained stable. Can you make a diagnosis?