Amalgam tattoo clinically presents most commonly as:

Correct answer: A. Bluish-gray, non-blanching flat macule near an amalgam restoration

• A. Correct. An amalgam tattoo appears as a flat, bluish-gray or dark macule typically adjacent to an amalgam restoration or in areas where amalgam particles were introduced during extraction or restorative procedures. It is non-painful, non-blanching, and visible on radiographs if the particles are large enough.
• B. A raised purple nodule describes pyogenic granuloma, Kaposi's sarcoma, or hemangioma.
• C. An erythematous irregular patch raises concern for erythroplakia or carcinoma.
• D. A white non-wipeable lesion describes leukoplakia or hairy leukoplakia.