10: Reactive Keratotic Lesions (Nonleukoplakias)

10 Reactive Keratotic Lesions (Nonleukoplakias)

Frictional/Factitial Immune-Mediated or Autoimmune Infectious Premalignant and Malignant Fibrosis (Not Involving the Epithelium)

The oral mucosa appears white for several reasons:

When a mildly irritating substance comes in contact with the mucosa or when there is mild physical surface trauma, superficial cells become edematous and degenerate until the effects of the irritation (contacting chemical or physical irritation) are diluted, beyond which the keratinocytes appear normal. Such changes are seen in leukoedema and morsicatio mucosae oris. Smokeless tobacco lesions in particular show this effect, although over time carcinogens from tobacco may result in significantly keratotic and dysplastic lesions. Aspirin, however, is so caustic that it leads to complete destruction of the epithelial layer, resulting in ulceration and necrosis rather than a keratotic lesion, although the earliest changes may be leukoedema. Irritant contact stomatitis results in a clinical erythematous lesion with spongiosis as its main histologic feature (see Chapter 7). Correlating the histopathologic and clinical findings is key to arriving at an accurate diagnosis.

Reactive Lesions


Jan 12, 2015 | Posted by in Oral and Maxillofacial Pathology | Comments Off on 10: Reactive Keratotic Lesions (Nonleukoplakias)
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