# Laugier-Hunziker Syndrome Diagnosed by a Medical Student After Multiple Failed Specialist Evaluations: A Case Report

## TL;DR

An 82-year-old woman with unexplained oral pigmentation was diagnosed with Laugier-Hunziker syndrome by a medical student after multiple specialists failed to identify the condition.

## Contribution

This case highlights the importance of considering rare diagnoses like LHS in elderly patients and the role of primary care in identifying them.

## Key findings

- Laugier-Hunziker syndrome was correctly diagnosed by a medical student after specialist evaluations failed.
- The patient's family history suggests possible familial or environmental influences, though no causal link was confirmed.
- Late-onset LHS in the elderly emphasizes the need for careful clinical assessment in primary care.

## Abstract

Laugier-Hunziker syndrome (LHS) is a rare, benign acquired pigmentary disorder characterized by mucosal macules that can resemble more serious systemic disease. We describe an 82-year-old woman with a four-year history of progressive oral hyperpigmentation involving the lower lip, buccal mucosa, and gingiva, with sparing of the tongue and upper lip, in whom repeated specialist evaluations had not yielded a diagnosis. A comprehensive clinical assessment in a family medicine clinic, including review of prior negative systemic workups, led a third-year medical student to recognize the pattern as LHS. The patient also reported similar pigmentary changes in her mother around the time of a lymphoma diagnosis, raising the possibility of familial or environmental influences, although no causal association could be established. This unusually late-onset presentation underscores the need to consider LHS in elderly patients with unexplained oral pigmentation and highlights the value of attentive history-taking and examination in primary care.