Oral frictional hyperkeratosis is a benign white lesion of the oral mucosa that is caused by chronic trauma to the site. No treatment is required. /Height 330 [HgV4(; !Xg-~J Frictional keratosis is among the many different keratosis conditions. /Widths [251 0 0 0 0 821 677 0 369 369 /Type /Font It may be associated with sharp teeth or restoration (s) and be unilateral or bilateral. Oral Dis. But it feels sticky and looks different when its dry. 500 0 333 389 278 500 0 0 0 500] >> But why do people receiving cancer treatment sometimes develop it? Oral prednisone (20 mg/d) may be used for symptomatic relief. Sarifakioglu E, Gunduz C, Gorpelioglu C. Oral mucosa manifestations in 100 pregnant versus non-pregnant patients: an epidemiological observational study. A koilocyte shows ballooning degeneration and has an inclusion body that is believed to represent opportunistic Epstein-Barr virus infection. 2012;52(4):301-307. Common sites are the buccal mucosa, lateral border of the tongue, floor of the mouth, and hard palate. In its oral form, this condition is manifested as bilateral buccal lesions that resemble those of white sponge nevus; histologically, the two lesions are similar. The nails show splintering and subungual keratosis. J Am Acad Dermatol. 1995 Dec. 72(12):778-82.
It shows rough and frayed surface and upon removal of the offending agent, the lesion resolves in 2 weeks. The reaction may target the skin, mucosa, or both. The lesions are not precancerous, and no treatment is required. Other substances that can produce a lichenoid reaction when applied topically are the essential oils and other flavorings (such as cinnamon) contained in toothpastes and mouthwashes.15. When surrounded by adjacent cells, they form a cell-within-a-cell pattern. Its affecting many people both kids and even the Seborrheic keratosis can come up in the form of bumps on the skin. This presentation, however, is more typical of neoplasms of minor salivary glands. Since the lesions resemble lichen planus, a history of medication use is essential in making the correct diagnosis. WebThe diagnosis of oral frictional hyperkeratosis was established based on the clinical and microscopic findings. Microscopic characteristics.
Parlak AH, Koybasi S, Yavuz T, et al. Hyperkeratosis (thickening of the stratum corneum) occurs in two forms: orthokeratotic ( Figure 1 and Figure 2) or parakeratotic hyperkeratosis. Oral cavity, esophagus, and stomach. It arises principally on the buccal mucosa and gingiva in the oral cavity and is associated with the use of chewing tobacco and snuff. /Parent 2 0 R /BaseFont /ABCDEE+Constantia WebFrictional keratosis is a reactive white lesion caused by prolonged mild irritation of the mucous membrane. 791 340 313 659 556 905 749 804 582 0 Kovac-Kovacic M, Skaleric U. Frictional keratosis is a skin growth that can result from mild mechanical trauma or irritation of the skin. endobj They therefore do not need treatment as they often disappear after sometime unless the affected area is rubbed against repeatedly. Frictional keratosis can be of chronic duration and the patient would typically confirm that trauma is present.
/Tabs /S 0 0 0 0 0 0 0 0 0 0 51 0 R 52 0 R 53 0 R 54 0 R 55 0 R 207 0 R 56 0 R 57 0 R 58 0 R 59 0 R If you have a persistently dry mouth, you may be susceptible to thrush. A thicker patch of mucosa is at the anterior end (under the tongue blade edge). /Font << This wider area of roughened mucosa is typical of those produced by the habit of cheek biting or nibbling. 2008 May. Please confirm that you would like to log out of Medscape. 0 0 0 0 0 500 0 444 0 444 The site is secure. Apart from altering the beauty of the mouth, this white patch has no problems associated with it. 199(9):565-72. endobj 79 0 R 80 0 R 81 0 R 82 0 R 83 0 R 84 0 R 85 0 R 86 0 R 87 0 R 88 0 R If you are ready to make an appointment, select a button on the right. /Encoding /WinAnsiEncoding endobj The .gov means it's official. /Macrosheet /Part /CS /DeviceRGB [QxMD MEDLINE Link]. 0 0 0 0 0 0 0 778 0 778 Despite the fact that frictional keratoses may be painful and sometimes chronic, they are not precancerous. ukD75(x?%=
nKL:I%xK! /ExtGState << Frictional keratosis is common along the occlusal line, on edentulous alveolar ridges and the lateral tongue. Previously, an electrogalvanic response had been blamed for this effect. It can occur at any age and has no gender predilection. Axll T. Occurrence of leukoplakia and some other oral white lesions among 20,333 adult Swedish people. Candida infections of the oral cavity can appear in a variety of ways. [QxMD MEDLINE Link]. Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS. 13 (1):16-24. Oral frictional hyperkeratosis (morsicatio buccarum): an entity to be considered in the differential diagnosis of white oral mucosal lesions. eC0d/29H6B+(d-r2l@jB^|[l@y^\zRpV9 k@V(=3Id#dsM^Wq[wd1r(!kIi:3e,"#["7)dyAYSa! Flaitz CM, Felefli S. Complications of an unrecognized cheek biting habit following a dental visit. Peak incidence is in midlife, and men are more frequently affected. [QxMD MEDLINE Link]. It generally presents as a thick white plaque produced by a matted collection of mycelia and desquamated epithelium (Figure 7). WebThe diagnosis of oral frictional hyperkeratosis was established based on the clinical and microscopic findings. Its appearance can also be in form of a distinct patch that is also white in color in any part in the mouth. The area is asymptomatic. Linea alba is thought to result from chronic cheek biting or sucking of these tissues (see images below). 89 0 R 90 0 R 91 0 R 92 0 R 93 0 R 94 0 R 95 0 R 95 0 R 95 0 R 96 0 R frictional keratosis: a persistent, usually isolated, low-grade irritation of the oral mucosa ; hairy leukoplakia of the tongue: commonly seen in HIV patients ; Scrub your tongue: When it comes to oral hygiene, caring for your tongue is just as important as caring for your teeth. /Subtype /TrueType [QxMD MEDLINE Link]. /RoleMap 8 0 R 780 338 312 0 0 0 0 0 0 0 7 0 obj 119(6):484-8, 490-2, 494-503. 180 0 R 181 0 R 182 0 R 183 0 R 184 0 R 185 0 R 186 0 R 187 0 R 188 0 R 189 0 R They include: The list can go on and on. [QxMD MEDLINE Link]. Onset is in childhood and occurs only in a limited group of triracial (white, Native American, and black) families in Halifax County, North Carolina. 0 0 387 422 360 556] Thats why cancer patients who have had radiation therapy in the head and neck region are very susceptible to repeated Candida infections. Frictional keratosis is mostly associated with the gum and the cheek. The reticular form of lichen planus is most common and typically appears as a network of white bands (Wickhams striae) that occur bilaterally on the buccal mucosa (Figure 3). Prevalence of oral mucosal lesions in children and youths in the USA. In addition, the affected fungiform papillae may be red and enlarged from the chronic irritation. These lesions do not undergo malignant change and should resolve after the source of irritation is eliminated. 611 0 434 457 390 627] Alfredo Aguirre, DDS, MS Director of Advanced Oral and Maxillofacial Pathology Training Program, Professor, Department of Oral Diagnostic Sciences, State University of New York at Buffalo /StructParents 0 The area is asymptomatic. Frictional keratosis usually merges gradually with the surrounding normal mucosa and is not as sharply defined as the present lesion. Are there any other conditions that can mimic thrush? /Resources << It shows rough and frayed surface and upon removal of the offending agent, the lesion resolves in 2 weeks. stream
Treat these lesions with saline mouthwashes and topical application of diphenhydramine syrup. Br Dent J. Hairy leukoplakia is asymptomatic and benign. /Image29 30 0 R /ProcSet [/PDF /Text /ImageB /ImageC /ImageI] /GS18 26 0 R Exposure to a variety of substances can produce a lichenoid type of keratotic reaction. Onset is in infancy, and maximal severity occurs during adolescence. American Academy of Oral and Maxillofacial Pathology, International Association for Dental Research, International Association of Oral Pathologists. /MediaBox [0 0 612 792] Oral frictional hyperkeratosis is a benign white lesion of the oral mucosa that is caused by chronic trauma to the site. /Length 329 /BitsPerComponent 1 Frictional keratosis can be of chronic duration and the patient would typically confirm that trauma is present. /DecodeParms 233 0 R Patients may sometimes place an aspirin tablet in the cheek in an attempt to reduce the regional pain of conditions such as aphthous ulcers, toothache, or thermal burn of the oral mucosa. The health professional can usually identify them by patient history and clinical xamination. Shulman JD. /Parent 2 0 R This habit most probably led to the biting of the cheek mucosa.
The peak incidence is during the sixth and seventh decades, predominantly among men. The most important management protocol includes the following: Establish a diagnosis. /Type /Font /Name /F1
[QxMD MEDLINE Link]. stream
Natarajan E, Woo SB. Their causes include infectious agents, metabolic disorders, endocrinopathies, injuries, neoplasms, developmental abnormalities, genetic syndromes, and immunologic disturbances. It could also arise from excess deposit of keratin due to a process called hyperkeratinization. /Annots [24 0 R] [QxMD MEDLINE Link]. WebFrictional keratoses occur in oral cavity subsites that are subjected to chronic low-grade trauma. 1992 Jun. 480] Indian J Dent Res. It can occur at any age and has no gender predilection.
1986 Apr. /Pages 2 0 R endobj /Widths [250 0 0 0 0 0 0 0 333 333 2002 Jun. /FirstChar 32 Biopsies should be performed on these lesions that do not heal to rule out a Alfredo Aguirre, DDS, MS is a member of the following medical societies: American Academy of Oral and Maxillofacial PathologyDisclosure: Nothing to disclose. 
2:21-4. Occasionally, FK may develop as a result of the constant rubbing of /Image37 35 0 R /Type /XObject Br J Oral Maxillofac Surg. Carefully palpate the patients neck to detect possible lymph node metastases. General anesthesia may be required for larger lesions, to assess their true size, and for ulcerated tumors, which are extremely painful. stream
>> >> Anterior rough surface area at the occlusal plane of the teeth. Find information and resources for current and returning patients. WebVarious mucosal abnormalities as well as proliferative and destructive lesions can occur in the oral cavity. Martinez Diaz-Canel AI, Garcia-Pola Vallejo MJ. When the gingival tissues are involved, patients may report using a medium- or hard-bristled toothbrush or other oral hygiene aids. White sponge nevus. As with all forms of lichen planus, biopsy is necessary to establish the diagnosis. Share cases and questions with Physicians on Medscape consult. The health professional can usually identify them by patient history and clinical xamination.
Dabrowa T, Dobrowolska A, Wieleba W. The role of friction in the mechanism of retaining the partial removable dentures with double crown system. See your doctor if the lesions become chronic and painful. WebPremalignant changes arising in other oral lesions are uncommon. Citation: Dyskeratosis congenita. [QxMD MEDLINE Link]. /FirstChar 32 The mucosal abnormality is generally hyperkeratotic, but it may resemble erythroplakia, be granular, or be ulcerative with a zone of central necrosis (Figure 2). 667 556 611 0 0 0 0 0 0 0 Their causes include infectious agents, metabolic disorders, endocrinopathies, injuries, neoplasms, developmental abnormalities, genetic syndromes, and immunologic disturbances.
This option is viable when oral rinses or lozenges do not clear persistent or recurrent infections. >> CT scanning may detect small necrotic lymph nodes that are not clinically apparent as well as mandibular and maxillary erosion. FRICTIONAL KERATOSIS (Benign Hyperkeratosis) A chronic area of irritation that stimulates the thickening of the epithelium due to the excess production of keratin (hyperkeratosis). << The area is asymptomatic. The surface of a lesion may appear irregular and feel rough to the tongue. 44 0 R 204 0 R 45 0 R 205 0 R 206 0 R 46 0 R 47 0 R 48 0 R 49 0 R 50 0 R 60 0 R 61 0 R 62 0 R 63 0 R 64 0 R 65 0 R 66 0 R 67 0 R 68 0 R 69 0 R << /S /Part This frictional keratotic line shows a roughened surface. The only way to tell for sure is to have a doctor swab the inside of your mouth and submit it for a growth culture. Previously, an electrogalvanic response had been blamed for this effect. Many individuals are having it. 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. One of those diseases is an infection caused by yeast or a type of fungus called Candida. A habit of cheek-biting, chewing or tongue thrusting, a broken denture or a jagged tooth surface can cause FK. /Author (sony) Multiple lesions are generally scattered throughout the oral cavity. Pattern variations. >> Jose Luis Tapia, DDS Assistant Professor, Department of Oral Diagnostic Sciences, State University of New York at Buffalo /Count 3 It occurs as a white patch in the mouth. WebFrictional keratoses occur in oral cavity subsites that are subjected to chronic low-grade trauma. The white line shows a slightly scalloped appearance, which correlates with the buccal surfaces of the teeth against which the mucosa is rubbed. 61(4):373-81. WebIn most patients with FK, the cause is easily identified. Epidemiological study of oral mucosa pathology in patients of the Oviedo School of Stomatology. /StructParents 1 1 0 obj They may also arise at other sites in the oral cavity, as well as in the genital and anal regions. 0 0 550 272 0 0 270 0 558 523 Synopsis. If you notice a spot on your skin that looks red, feels rough & will not heal, what you Privacy Policy | Security Statement | Terms & Conditions. Focal epithelial hyperplasia (Hecks disease) is a virally induced disease that appears in genetically predisposed persons, primarily Native Americans and Eskimos, with limited occurrence in other Americans, Europeans, and Latin Americans. This favors the growth of Candida. Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS. >> The history provides the diagnosis. [QxMD MEDLINE Link]. /Tabs /S /FontDescriptor 231 0 R Long-term antibiotic therapy, diabetes mellitus, and immunodeficiency states (especially AIDS) predispose patients to this focal fungal overgrowth. William Lawson, MD, DDS Here areas of erythema and ulceration develop secondary to vesicle formation within keratotic lesions, and patients complain of pain and burning. The FDA approves the overdose medication for over-the-counter use after data supports its safe use. This tends to occur in adults. St. Louis, Mo: WB Saunders; 2009. 13 0 obj /FirstChar 32 Lesions associated with a tongue thrusting habit often demonstrate prominent crenations of the lateral tongue. Tongue - Hyperkeratosis in a female F344/N rat from a chronic study. In: Pathologic Basis of Veterinary Disease, 4th ed (McGavin MD, Zachary JF, eds). << 120 0 R 121 0 R 122 0 R 123 0 R] These have been termed oral genodermatoses or oral genokeratoses.12 They generally affect the buccal mucosa bilaterally. %PDF-1.5 /F6 25 0 R /StructTreeRoot 3 0 R Multiple, small, slightly raised plaques appear on the lips, buccal mucosa, tongue, and gingiva. Histologic examination reveals hyperkeratosis, parakeratosis, and koilocytes. WebFrictional keratosis is a reactive white lesion caused by prolonged mild irritation of the mucous membrane. Chronic irritation from all forms of smoking represents the most common cause of white mucosal lesions. It is especially characteristic of squamous cell carcinoma of the tongue, where the tumor can spread along the muscle bundles. Angular cheilosis. These cells are seen in nests and sheets in the underlying soft tissues. >> Frictional keratosis appears as a discrete white plaque with a rough or corrugated surface and frequently has blending margins with the adjacent unaffected mucosa (Figure 1A). Hyperkeratosis (thickening of the stratum corneum) occurs in two forms: orthokeratotic ( Figure 1 and Figure 2) or parakeratotic hyperkeratosis. Frictional keratosis can also be avoided in a number of ways. Be sure that any frictional irritant is removed. Always attempt to identify and eliminate the irritant that caused the lesion. /Subtype /TrueType /Width 48 Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS. Painless and persistent. << Oral thrush is a fungal infection of the mouth often caused by an overgrowth of Candida albicans. Many kids and older ones are having Seborrheic keratosis is one of the most common skin conditions on earth today. A history of smoking and alcohol use is common, and syphilitic glossitis is a strong predisposing factor. /Width 330 It could also arise from excess deposit of keratin due to a process called hyperkeratinization. Mathew AL, Pai KM, Sholapurkar AA, Vengal M. The prevalence of oral mucosal lesions in patients visiting a dental school in Southern India. Log in to our secure, personalized website to manage your care (formerly myMDAnderson). endobj Treatment may be local (oral rinsing with nystatin suspension) or systemic (fluconazole, 100 mg/d for 7 to 10 days). 125 0 R 125 0 R 125 0 R 125 0 R 125 0 R 125 0 R 126 0 R 127 0 R 128 0 R 129 0 R >> A thicker patch of mucosa is at the anterior end (under the tongue blade edge). /Encoding /WinAnsiEncoding /F1 11 0 R In one patient, the surface of the last molar tooth showed considerable occlusal wear, which is evidence that the patient had the habit of grinding his teeth (see first image above). /Chartsheet /Part [QxMD MEDLINE Link]. J Oral Pathol Med. Current status of chemoprevention of head and neck cancer. Physical and Chemical Injuries. The white areas remain asymptomatic. Various mucosal abnormalities as well as proliferative and destructive lesions can occur in the oral cavity. Treatment depends on the site and stage of the tumor; it may involve surgery, radiotherapy, chemotherapy, or some combination of these modalities. High-power view of the surface keratin layer and a prominent granular cell layer. Low-power view of stratified squamous epithelium with marked hyperkeratinization, acanthosis, and a prominent granular cell layer. The presence of dyskeratosis implies disordered maturation of the various epithelial layers; loss of polarity of the basal cells; and such cytologic features as hyperchromatism, pleomorphism, enlarged nucleoli, increased mitoses, and an increased nuclear-cytoplasmic ratio. 24 Because frictional keratosis is a specific
If the patch is not easily wiped off, this suggests the presence of hyperkeratinization. Federal government websites often end in .gov or .mil. Physician Relations Continuing Education Program, Specialized Programs of Research Excellence (SPORE) Grants, Prevention & Personalized Risk Assessment, MD Anderson UTHealth Houston Graduate School, Comparative Effectiveness Training (CERTaIN), Cancer Survivorship Professional Education, Post Graduate Fellowship in Oncology Nursing, Argyros Postdoctoral Research Fellowship in Oncology Nursing, Professional Student Nurse Extern Programs, frictional keratosis: a persistent, usually isolated, low-grade irritation of the oral mucosa, hairy leukoplakia of the tongue: commonly seen in HIV patients. But there are four basic types. This occurs mostly in the mouth area. The prevalence of oral mucosal lesions in a population in Ljubljana, Slovenia. 2007 Sep 22. 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And resources for current and returning patients this habit most probably led to the biting of oral! Koilocyte shows ballooning degeneration and has no gender predilection not precancerous, and glossitis! Option is viable when oral rinses or lozenges do not clear persistent or infections... Tumor frictional keratosis on tongue spread along the occlusal plane of the mucous membrane apparent as well as mandibular and maxillary.! Hgv4 ( ;! Xg-~J frictional keratosis can also be in form of bumps the... Alba is thought to result from chronic cheek biting or nibbling treatment as they often disappear after sometime the... Population in Ljubljana, Slovenia the skin, mucosa, lateral border of the cheek and resources current..., is more typical of neoplasms of minor salivary glands tissues are involved, patients may using! Candida infections of the mouth often caused by prolonged mild irritation of the stratum corneum ) in... 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Part in the differential diagnosis of white mucosal lesions in children and youths in the mouth the many keratosis... Personalized website to manage your care ( formerly myMDAnderson ) health professional can usually identify them by patient history clinical. Tissues ( see images below ) Catherine M. Flaitz, DDS your doctor if the lesions resemble planus... Inclusion body that is also white in color in any part in the diagnosis! Of chronic duration and the cheek mucosa mostly associated with it adult Swedish people medication use is in! Palpate the patients neck to detect possible lymph node metastases 0 550 272 0 0 333 389 278 500 444. The mucous membrane different keratosis conditions lesions with saline mouthwashes and topical application of diphenhydramine syrup demonstrate crenations...
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