38 White lesions: Keratosis, leukoplakia
Definition: White lesion caused by repeated trauma.
Prevalence (approximate): Common.
Age mainly affected: Middle-age and older.
Gender mainly affected: M > F.
Etiopathogenesis: Etiological factors include prolonged abrasion (e.g. sharp tooth, dental appliance, toothbrushing, mastication, cheek biting). Bilateral alveolar ridge keratosis (BARK) may be seen in edentulous areas. An occlusal line (linea alba) is often seen on the lateral tongue (Figure 38.1) and in the buccal mucosae (Figure 38.2), as is cheek-biting (morsicatio buccarum or morsicatio mucosa oris, MMO), most prevalent in anxious females (Figure 38.3). Rarely self-mutilation is seen in psychiatric disorders (Figure 38.4), learning impairment or some rare syndromes.
Linea alba is typically thin, white with occasional petechiae and may be seen in isolation or />