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

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.