Non-HPV Papillary Lesions of the Oral Mucosa: Clinical and Histopathologic Features of Reactive and Neoplastic Conditions

Mainville, Gisèle N.

doi:10.1007/s12105-019-01001-9

Cited by 16 publications

(10 citation statements)

References 46 publications

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“…Floor of the mouth is an even more unusual location for VX [21] with 1.42% (n = 3) lesions seen in here. Contrary to cutaneous xanthomas, oral VX are not associated with hyperlipidemia or underlying disease, such as xanthelasma palpebrarum, hyperlipidemia, and juvenile xanthogranuloma [11].…”

Section: Intra-oral Locationmentioning

confidence: 91%

“…The etiology and pathogenesis of VX remains unclear, with a number of studies investigating the molecular structure and immunoprofile of these lesions [11]. However, two main hypotheses have been proposed in the literature.…”

Section: Etiologymentioning

confidence: 99%

“…the acanthotic squamous epithelial ridges of uniform depth [11]. These lipid-laden foamy macrophages, commonly known as xanthoma cells, are believed to be a response to trauma or chronic inflammation.…”

Section: Introductionmentioning

confidence: 99%

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Oral Verruciform Xanthoma: A Series of 212 Cases and Review of the Literature

Belknap

Islam

Bhattacharyya

et al. 2020

Head and Neck Pathol

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Verruciform xanthoma (VX) of the oral cavity is an uncommon, reactive lesion of unknown etiology. In this study, we present a large series of VX with analysis of demographics, clinical appearance, histologic presentation and extensive review of literature. To the best of our knowledge, this is the largest series of oral VX reported to date. Following IRB approval, all cases diagnosed as VX found in the archives of the University of Florida Oral Pathology Biopsy Service were included. Patient age, gender, location, clinical appearance, clinical impression, and duration of each lesion was collected. A total of 212 cases were included in our database with a mean age of 61 years (range of 9-94), and a female: male ratio of 1.06:1. The most common location in descending order was the gingiva (n = 110, 51.2%), followed by palate (n = 41, 19.3%), buccal mucosa (n = 18, 8.5%), tongue (n = 20, 9.4%), vestibule (n = 13, 6.1%), lip (n = 4, 1.9%), floor of mouth (n = 3, 1.4%), and unspecified (n = 1, 0.5%). The lesions were most frequently pink in color, and most often described as bumpy, rough, verrucoid and/or papillary. Clinical impression in descending order was papillary (n = 67, 31.6%), not specified or unknown (n = 41, 19.3%), hyperkeratosis (n = 24, 11.3%), fibroma (n = 20, 9.4%), leukoplakia (n = 17, 8.0%), dysplastic lesion (n = 13, 6.1%), pyogenic granuloma (n = 7, 3.3%), granulomatous reaction (n = 5, 2.4%), lichen planus, VX (n = 4 each, 2.0%), pigmented, other lesions (n = 3 each, 1.4%), and salivary and periapical lesions (n = 2 each, 0.9%). Three of the lesions were recurrences. The demographics and clinical parameters of this case series were in concordance with that of previously published reports. In our series, only 4 cases were suspected as VX, demonstrating the lack of familiarity clinicians have with this lesion.

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Section: Intra-oral Locationmentioning

confidence: 91%

Section: Etiologymentioning

confidence: 99%

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Oral Verruciform Xanthoma: A Series of 212 Cases and Review of the Literature

Belknap

Islam

Bhattacharyya

et al. 2020

Head and Neck Pathol

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“…Oral verruciform xanthoma (OVX) is an uncommon benign lesion of purportedly reactive or immunologic origin. 5,6 Most patients are males in the 40À69-year age group. OVX manifests as a small, asymptomatic, solitary plaque on the gingiva/alveolar mucosa; its surface is described as papillary, granular, or verrucous, and its color ranges from white to red or pink.…”

Section: Differential Diagnosismentioning

confidence: 99%

A solitary, red, papillary–verrucous lesion on the mandibular alveolar mucosa

Tosios

Kalogirou

Nikitakis

2021

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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CLINICAL PRESENTATION A 60-year-old Caucasian male was referred by his dentist for diagnosis and management of an asymptomatic lesion, incidentally discovered during a routine dental examination. According to the patient, this was his first dental visit after more than 5 years. His medical history was significant for iron deficiency anemia; he had been smoking 10 cigarettes per day for about 42 years. Clinical examination revealed a round, well-circumscribed, red, plaque-like lesion with a papillaryÀverrucous surface on the alveolar ridge distally to the decayed root of the mandibular right first premolar, measuring 0.8 £ 0.5 cm (Figure 1). It was nontender on palpation, and the patient did not report pain or other neurologic symptoms in the area. There were numerous dental and periodontal problems, but the rest of the oral mucosa was normal. Cone beam computed tomography (CBCT), requested by his dentist for the preoperative planning of oral implant rehabilitation, did not reveal any bone abnormality in the area of concern (Figure 2, arrow).

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“…1 Hairy tongue appears as a hairy coating on the tongue's dorsum, sparing the tip and lateral borders. 2 The colour ranges from cream to brown to black, depending on extrinsic factors, such as diet and smoking, and intrinsic factors, such as chromogenic bacteria and fungi). 1,3 Hairy tongue is usually asymptomatic.…”

mentioning

confidence: 99%

Hairy tongue

Burge

Kogilwaimath

2021

CMAJ

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A 55-year-old man developed a new, hair-like coating on his tongue after a month in the intensive care unit (ICU) with Guillain-Barré syndrome. He had been intubated for 11 days and had had a tracheostomy. Aside from distress about the appearance of his tongue, he was concerned about a decreased sense of taste. The patient had no other oral complaints. He had a 30 pack-year history of smoking. During his stay in the ICU, he received piperacillin-tazobactam, trimethoprim-sulfamethoxazole, ciprofloxacin and quetiapine. The patient's management team initially diagnosed oral candidiasis and treated him with several courses of oral nystatin and systemic fluconazole. Nonresponse to antifungal medications, combined with a typical clinical appearance and history, led us to diagnose hairy tongue (Figure 1).Hairy tongue is a benign condition resulting from elongation of the filiform papillae because of keratin build up. This can result from inadequate exfoliation (e.g., from decreased oral intake, poor oral hygiene or dry mouth related to anticholinergic drugs) and accelerated keratinization (as may occur with irritation from smoking). 1 Hairy tongue appears as a hairy coating on the tongue's dorsum, sparing the tip and lateral borders. 2 The colour ranges from cream to brown to black, depending on extrinsic factors, such as diet and smoking, and intrinsic factors, such as chromogenic bacteria and fungi). 1,3 Hairy tongue is usually asymptomatic. While the diagnosis is clinical, tongue biopsy may rarely be required to clarify the diagnosis if the lesion does not respond to conservative management. 1 As with our patient, hairy tongue is frequently confused with pseudomembranous candidiasis and treated ineffectively with antifungal therapy. 3 The management of hairy tongue consists primarily of gentle débridement with a soft-bristled brush along with reassurance. 1 Aggravating agents should be discontinued, and risk factors modified where possible. Hairy tongue often resolves spontaneously.We think our patient's hairy tongue was caused by a prolonged period of limited oral intake, xerostomia related to the anticholinergic effects of quetiapine and a change in oral flora from various courses of antimicrobials. The patient's tongue improved substantially after 2 months.

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Non-HPV Papillary Lesions of the Oral Mucosa: Clinical and Histopathologic Features of Reactive and Neoplastic Conditions

Cited by 16 publications

References 46 publications

Oral Verruciform Xanthoma: A Series of 212 Cases and Review of the Literature

Oral Verruciform Xanthoma: A Series of 212 Cases and Review of the Literature

A solitary, red, papillary–verrucous lesion on the mandibular alveolar mucosa

Hairy tongue

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