frictional keratosis on tongue

[QxMD MEDLINE Link]. Oral Dis. In most cases, oral frictional keratosis appears as a thin line that is white in color across the cheek opposite the meeting point of the teeth. This feature distinguishes leukoedema from frictional keratosis, lichen planus and leukoplakia. A patient may notice a thickening or roughness of the involved mucosal site, or frictional keratosis may be discovered as an incidental finding during a routine oral examination. Scattered throughout the epithelium but most appreciated in the upper spinous layer are dyskeratotic cells. Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS. squamous cell carcinoma). The affected area may exhibit a macerated appearance with shredded keratin and peeling (Fig. Oral and Maxillofacial Pathology. External factors that mostly cause frictional keratosis are through smoking though that occurs mostly in lips. An official website of the United States government. This may also be seen on vestibular mucosa in areas where loose dentures chronically and mildly push against the mucosa. about navigating our updated article layout. We report the first example, to our knowledge, of a frictional keratosis from exuberant sucking in a breastfeeding infant. Other findings include a mixed inflammatory infiltrate, including eosinophils, and focal perivascular inflammation [28, 29]. 2010 May. The https:// ensures that you are connecting to the 2012 Mar-Apr. Prominent linea alba with evidence of cheek biting. Definition Frictional keratosis is a white, keratotic lesion due to chronic mechanical irritation caused by sharp edges of teeth or restorations, dental prosthesis, abrasive foods, vigorous tooth brushing, and playing wind instruments. (1) Leukoplakia and erythroplakia are two clinical lesions widely considered to be premalignant. The clinical effectiveness of reflectance optical spectroscopy for the in vivo diagnosis of oral lesions. Frictional Keratosis, Contact Keratosis and Smokeless Tobacco Keratosis: Features of Reactive White Lesions of the Oral Mucosa. Typically, the lesions appear as distinct, focal, and translucent-to-opaque white asymptomatic patches with sharply delineated borders. This occurs when the tongue constantly rubs against one's teeth. 7 Oral frictional keratosis lesions typically reduce or resolve . Admittedly there is histologic overlap with oral lichen planus and amalgam contact reactions however some microscopic findings may favor a contact reaction (Fig. Leukoplakia is a patch that is white to gray in color. A 2-month-old girl was referred for evaluation of a well-demarcated, nonsloughing white keratotic plaque of the lower lip mucosa, just inside the vermilion border. The erosive form of lichen planus must be considered separately. 13 (1):16-24. It shows rough and frayed surface and upon removal of the offending agent, the lesion resolves in 2 weeks. Skaare A, Eide G, Herlofson B, Barkvoll P. The effect of toothpaste containing triclosan on oral mucosal desquamation. Various names have been used to describe particular examples of frictional keratosis (FK). It can also lead to serious complications and timely diagnosis and treatment is necessary. The https:// ensures that you are connecting to the On initial examination, the patient was asymptomatic and the oral mucosa had no abnormal findings, but on repeat examination when symptoms were present, the patient had shaggy white plaques on the bilateral buccal mucosa limited to the line of dental occlusion (Figure 1). MeSH Int J Oral Sci. [QxMD MEDLINE Link]. Biopsies of affected mucosa however rule out vesiculo-bullous disease, as the histology shows acanthosis and intracellular edema of the stratum spinosum. keratin layer on the surface of the tongue is thickened (arrow). There are some very simple treatment methods that do not Are you suffering from age spots and want to remove them but don't know how? [QxMD MEDLINE Link]. 2006 Nov-Dec. 16(6):674-6. A ten-year follow-up. Smith JF. The patient denied any history of trauma, cheek biting, or use of tobacco products. HHS Vulnerability Disclosure, Help Axll T. Occurrence of leukoplakia and some other oral white lesions among 20,333 adult Swedish people. Within the spinous layer occasional cells with bright eosinophilic perinuclear condensation representing keratin tonofilaments can be observed. 2a). The production of keratin is increased in areas which . 8 These lesions have been observed on multiple surfaces, including the tongue, buccal mucosa, gingiva, and alveolar ridges. Nonetheless, this condition should be treated during its initial stages to achieve best results. 1992 Jun. Daniel J Hogan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Contact Dermatitis Society, Canadian Dermatology AssociationDisclosure: Nothing to disclose. . McParland H, Warnakulasuriya S. Oral lichenoid contact lesions to mercury and dental amalgama review. Frictional keratosis is among the many different keratosis conditions. The histological findings of STK though not unique have characteristic findings. Conclusions: MMO is a form of chronic oral frictional keratosis that has no malignant potential, and should be signed out as such and not merely "hyperparakeratosis and acanthosis" so that it can be removed from the category of leukoplakia where it does not belong. Frictional keratosis presents as a white lesion (macule or plaque) determined by repeatedly trauma, in turn caused by particularly sharp dentures, ill-fitting dentures or poor oral habits (e.g. Frictional keratosis from the alveolar ridge usually is surfaced by orthokeratin with a slightly irregular or corrugated architecture (Fig. The palate, particularly the soft palate, is affected. Head Neck Pathol. Frictional keratosis2 1. Kovac-Kovacic M, Skaleric U. Madani FM, Kuperstein AS. . as frictional keratosis, which occurs ble cottage cheese or curdled milk.1,2 Although culture or cytopathologic tis- under a variety of diagnostic names Scraping the plaques with a tongue sue staining conrms the diagnosis, (Table 1). Larsson A, Axll T, Andersson G. Reversibility of snuff dippers lesion in Swedish moist snuff users: a clinical and histologic follow-up study. WSN is inherited as an autosomal dominant trait that presents as asymptomatic thickened soft white plaques most commonly on the buccal mucosa (Fig. Please enable it to take advantage of the complete set of features! Nevertheless, if any of the frictional keratosis fails to fade after four weeks, it is recommended that you visit your doctor for accurate diagnosis and treatment. PMC The effects of the habit of chronic biting may also manifest on the anterior and lateral borders of the tongue and appear as white, shaggy or mildly wrinkled plaques (see image below). 2009 Jan;67(1):140-6. doi: 10.1016/j.joms.2008.08.040. Leukoedema and hereditary genodermatoses that may enter in the clinical differential diagnoses of frictional keratoses including white sponge nevus and hereditary benign intraepithelial dyskeratosis will be reviewed. sharing sensitive information, make sure youre on a federal Martelli H, Jr, Pereira SM, Rocha TM, Nogueira dos Santos PL, Batista de Paula AM, Bonan PR. 14(4):367-75. Its appearance can also be in form of a distinct patch that is also white in color in any part in the mouth. I bought a new waterpik today and when I used it the first time, there was a lot of blood in the sink. Results from periodic acid-Schiffstain revealed no fungal elements. It might have already appeared on you Privacy Policy | Security Statement | Terms & Conditions, Seborrheic Keratosis Removal With Hydrogen Peroxide, Home Remedy For Removing Seborrheic Keratosis, Herbal Treatment For Seborrheic Keratosis. The clinical findings are critical in helping to distinguish between reactive keratosis and OPMD. High-power view of the surface keratin layer and a prominent granular cell layer. 10(2):114-5. Perivascular inflammation in the deeper lamina propria is present, a feature not typical for oral lichen planus (H&E magnification 40). 2004 Sep. 135(9):1279-86. It can occur also at any age. PVL lesions histologically can have a varied appearance and usually corresponds to the clinical appearance. Biting, sucking, or chewing habits should be discontinued, and fractured or rough tooth surfaces or irregularly fitting dentures or other appliances should be corrected. [QxMD MEDLINE Link]. The number of people suffering from seborrheic keratosis is on the increase. 2015 Aug 1. Eczema is also called dermatitis. This tends to occur in adults. A thicker patch of mucosa is at the anterior end (under the tongue blade edge). This lesion is caused by masticatory irritation. [4] The formation rate depends on the frequency of habit, dose, and even the brand used. The whiteness is as a result of more cells being set by the body as it reacts to the irritation caused by friction. Total resolution of the condition was achieved upon discontinuation of the tartar control toothpaste. Most of these lesions are incidental findings and relate to a variety of causes including parafunctional habits, mechanical friction, contact reactions, chemical-related changes, and tobacco-related changes [25]. a Superficial sloughing of the oral mucosa due to the use of triclosan and pyrophosphate containing toothpaste. Some patients report that their cheeks and tongue feel swollen. Evidence-based clinical recommendations regarding screening for oral squamous cell carcinomas. Hereditary benign intraepithelial dyskeratosis: an evaluation of diagnostic cytology. The white line observed on the cheek is level with the biting plane of the teeth. . The retromolar pad and edentulous alveolar ridge can exhibit benign keratosis as the area is susceptible to both masticatory forces, occlusal trauma or ill-fitting dentures or other dental appliances (Fig. Martinez Diaz-Canel AI, Garcia-Pola Vallejo MJ. The epithelium may show acanthosis and epithelial rete may be elongated or atrophic [ 9, 10 ]. This is in contrast to the diffuse, ill-defined keratotic plaques seen in proliferative verrucous leukoplakia (Fig. East Afr Med J. 2015 Dec. 34 (4):161-70. J Oral Pathol Med. Daniel J Hogan, MD Clinical Professor of Internal Medicine (Dermatology), Nova Southeastern University College of Osteopathic Medicine; Investigator, Hill Top Research, Florida Research Center Signs and Symptoms of Leukoplakia. Benign alveolar ridge keratosis (oral lichen simplex chronicus): a distinct clinicopathologic entity. The wear on the occlusal surfaces of the molar teeth suggests that the patient had a habit of bruxism. J Am Acad Dermatol. Oral contact lesions to amalgam dental restorations can present as a keratotic or lichenoid lesion (Fig. 7-2a) [30, 31]. These lesions can occasionally mimic dysplastic leukoplakia. They include: The list can go on and on. The 3rd is about a week ago showing the way it's raised. This lesion should quickly resolve after removal of the provoking stimulus. Various names have been used to describe particular examples of frictional keratosis (FK). Frictional Keratosis. Corresponding to the clinical presentation, the surface keratin can have a macerated appearance with fissures and clefting [6, 8]. The first image below shows a frictional keratosis lesion that displays marked keratinization. Cai W, Jiang B, Yu F, Yang J, Chen Z, Liu J, Wei R, Zhao S, Wang X, Liu S. Current approaches to the diagnosis and treatment of white sponge nevus. A prominent granular cell layer is noted. Scully C. Cannabis; adverse effects from an oromucosal spray. This is the American ICD-10-CM version of K13.21 - other international versions of ICD-10 K13.21 may differ. It occurs as a white patch in the mouth. This pattern may be misdiagnosed as a fungal infection. The histologic features of frictional keratosis from the tongue, lip or buccal mucosa vary slightly depending on the site of the biopsy. The careful evaluation of sharp dental margins or cuspid fractures and incongruous fillings can cause hyperkeratotic traumatic reactions at the site where they persist [ 22 ]. Medscape Education, A Genitourinary Overview of Bladder and Prostate Cancers, encoded search term (Oral Frictional Hyperkeratosis) and Oral Frictional Hyperkeratosis. [QxMD MEDLINE Link]. Frictional keratosis - Usually seen at sites of trauma from teeth, also along buccal occlusal line and occasionally beside an outstanding tooth, or on edentulous ridge. Mller S. Oral epithelial dysplasia, atypical verrucous lesions and oral potentially malignant disorders: focus on histopathology. epigenetics; oral epithelial dysplasia; oral squamous cell carcinoma; 5-hydroxymethylcytosine Catherine M Flaitz, DDS, MS Professor of Oral and Maxillofacial Pathology and Pediatric Dentistry, Department of Diagnostic and Biomedical Sciences, University of Texas Health Sciences Center at Houston School of Dentistry, Catherine M Flaitz, DDS, MS is a member of the following medical societies: American Academy of Oral and Maxillofacial Pathology, American Academy of Oral Medicine, American Academy of Pediatric Dentistry, American Dental Association, International Association for Dental Research, and International Association of Oral Pathologists, Disclosure: Trimira, LLC Clinical contract for study Co-investigator on clinical grant; Trimira, LLC Honoraria Speaking and teaching; GC America Clinical contract for study Co-investigator on clinical grant; Forward Science LLC Device evaluation Product evaluation for school use. Included in the discussion are frictional keratoses, irritant contact stomatitis, and smokeless tobacco keratoses. Contact allergy to cinnamon: case report. Hassona Y, Scully C. Oral mucosal peeling. Disclaimer, National Library of Medicine However, most traumatized gingiva of the tooth bearing area expresses as erythema, ulceration, or other reactive lesions such as pyogenic granuloma. A mild lymphoplasmacytic infiltrate in the subepithelial lamina propria is typical. Collagen sclerosis appearing as a band of homogeneous, acellular eosinophilic amyloid-like material has been reported (Fig. Patients may report that they are aware of sucking the mucosa or thrusting their tongue against their teeth. My tongue is very irritated right now from eating spicy food. Localized hair loss. Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS. b Biopsy shows a corrugated or slightly papillary epithelial architecture with hyperorthokeratosis, a prominent granular cell layer but normal epithelial maturation. Jose Luis Tapia, DDS Assistant Professor, Department of Oral Diagnostic Sciences, State University of New York at Buffalo 2007 Sep 22. lesions appear as white patches in oral cavity. Triamcinolone 0.1% ointment in Orabase and tretinoin 0.05% gel were ineffective. The diagnosis of oral frictional hyperkeratosis was established based on the clinical and microscopic findings. Numerous papers have been published on the clinical and histologic features of oral leukoplakia and will not be repeated herein. Introduction. It had been around for long now and there is rarely Seborrheic keratosis can come up on any part of the body. Therefore, it is prudent to sample any questionable lesion to rule out OPMD. Prevalence of oral mucosal lesions in children and youths in the USA. The epithelium exhibits epithelial hyperplasia and intracellular edema is common presenting as ballooned cells in the spinous layer. The inflammation unlike oral lichen planus is composed of lymphocytes, plasma cells and scattered eosinophils. Leukokeratosis of oral mucosa. The connective tissue lacks inflammation. Chi AC, Lambert PR, 3rd, Pan Y, Li R, Vo DT, Edwards E, Gangarosa P, Neville BW. Mathew AL, Pai KM, Sholapurkar AA, Vengal M. The prevalence of oral mucosal lesions in patients visiting a dental school in Southern India. The site is secure. Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS. 1a). WHO classification of tumours of the head and neck. A frictional keratosis lesion may be elevated from the surface, and patients may find that they develop the habit of nibbling further at these thickened mucosal sites. Macdonald JB, Tobin CA, Hurley MY. One of the more common presentations of frictional keratosis is the linea alba (white line). Toothbrush keratosis can develop when a person uses excessive force while brushing teeth and causes inflammations in ones mouth. Morsicatio mucosae oris--a chronic oral frictional keratosis, not a leukoplakia. (H&E magnification 400). 1980. Epidemiological evidence relating snus to healthan updated review based on recent publications. Similar to WSN, HBID presents as white spongy plaques on the buccal mucosa and tongue, but in addition, HBID has ocular findings of white gelatinous conjunctival plaques [19]. Community Dent Oral Epidemiol. Is alveolar ridge keratosis a true leukoplakia? The myriad of clinical findings of reactive white lesions can be challenging when attempting to distinguish from other disorders, including OPMDs. A leukoplakia doesn't usually line up with anything obvious, is frequently bilateral, and usually affects the floor of the mouth (under the tongue) or the lower side of the tongue. . It is more common in African-Americans than in white Americans occurring in 49% of African-Americans and in 4% of white Americans in one survey of 13,000 patients [15]. Cam K, Santoro A, Lee JB. Two rare genodermatoses that can have clinical overlap with frictional keratoses but have distinct histologic features are white sponge nevus (WSN) and hereditary benign intraepithelial dyskeratosis (HBID). Cytology of linea alba using a filter imprint technique. Although the vast majority of publications focus on leukoplakia and other potentially malignant lesions, most oral lesions that appear white are benign. 5 inset). Perivascular inflammation composed of lymphocytes and plasma cells are observed in the deeper lamina propria. 141(5):509-20. c Photomicrograph of smokeless tobacco keratosis shows a corrugated parakeratotic surface and epithelial acanthosis. A persons mouth is one of the most sensitive and important parts of the human body and should therefore be protected from any form of friction or irritation that has potential to cause frictional keratosis. Macigo FG, Mwaniki DL, Guthua SW. 2000. A clinicopathologic comparison of 2,153 lesions. 1c Interface mucositis in amalgam contact reactions are seen and the dense lymphocytic infiltrate can form tertiary follicles (arrow) (H&E magnification 100). Share cases and questions with Physicians on Medscape consult. Miller RL, Gould AR, Bernstein ML. Frictional keratosis Frictional keratoses occur in oral cavity subsites that are subjected to chronic low-grade trauma. Frictional keratosis from the alveolar ridge usually is surfaced by orthokeratin with a slightly irregular or corrugated architecture (Fig. Of unknown etiology, PVL is associated with high recurrence and malignant transformation rates. Accessibility Most cases of cinnamon stomatitis are associated with prolonged contact of the offending agent. Frictional keratosis. 2000 Aug. 29(7):331-5. Note the large amalgam restorations that directly contacts the affected mucosa. Within 10 days of discontinuing the gum, the lesion completely resolved. a Leukoedema of the left buccal mucosa in a 58-year-old Black female presenting as an ill-defined opalescent filmy gray to white lesion. a Typical clinical presentation of an early smokeless tobacco keratosis demonstrating an area of superficial keratosis with slight wrinkling, lacking any appreciative mucosal thickening. Frictional Keratosis. PMC legacy view 2008 Apr-Jun. The gingiva is the most common site for PVL and in a 2014 systematic review of PVL, the gingiva was the most common site for malignant transformation [11]. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. b Photomicrograph demonstrates marked parakeratosis, acanthosis and intracellular edema. Frictional keratosis is a reactive white lesion caused by prolonged mild irritation of the mucous membrane. However, if lesions persist, complete removal is advisable. White lesions of the oral cavity are quite common and can have a variety of etiologies, both benign and malignant. Adv Dermatol. This occurs mostly in the mouth area. In most cases, oral frictional keratosis appears as a thin line that is white in color across the cheek opposite the meeting point of the teeth. A dense inflammatory cell infiltrate is seen in the superficial lamina propria and generally extends deeper into the lamina propria around vascular spaces (H&E magnification 100). In the 2005 WHO section of epithelial precursor lesions, squamous cell hyperplasia was considered a precursor lesion and thus, termed leukoplakia [2]. Mravak-Stipeti M, Lonar-Brzak B, Bakale-Hodak I, Sabol I, Seiwerth S, Majstorovi M, Grce M. Clinicopathologic correlation of oral lichen planus and oral lichenoid lesions: a preliminary study. Marked hyperkeratosis, either orthokeratosis or parakeratosis and neutrophilic exocytosis is present. Leukoplakia, lichen planus, and other oral keratoses in 23,616 white Americans over the age of 35 years. The patient denied biting her tongue and the histology is not consistent with chronic tongue chewing/biting. Figure 2 Tongue - Hyperkeratosis in a female F344/N rat from a chronic study (higher magnification of Figure 1). Federal government websites often end in .gov or .mil. 3-Abnormal permeability of epithelium. b When the cheek is everted and stretched the lesion diminishes. However, with increased concentration, duration, or frequency of the chemical the patient may have a reaction and develop keratoses, ulcerations, vesicles, erythema, edema or a combination of these. [QxMD MEDLINE Link].

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