White sponge nevus: A condition not always clinically suspected

Abstract

White sponge nevus (WSN) is an uncommon benign inherited disorder characterized bywhite and diffuse painless lesions in oral, esophageal, or genital mucosa. The lesions may develop at birth or later in childhood or adolescence, with careful clinical examination being sufficient for diagnosis in most cases. However, microscopic analysis may be necessary particularly in adults in which other whitish oral lesions may be clinically suspected.Dermatologists, dentists, and pathologists should consider WSN when evaluating multiple white oral lesions, thus preventing unnecessary treatments. Herein, we report four additional cases of WSN with emphasis on its clinical and histopathological features. K E Y W O R D S oral mucosa, white lesions, white sponge nevus

A 15‐month‐old boy with white plaques on the oral mucosa

“…Cells within the spinous layer often display perinuclear eosinophilic condensation of the cytokeratin filaments 3 . Our patient presented with perinuclear eosinophilic condensations, as well as hyperparakeratosis, acanthosis, and vacuolization of the suprabasal layers, all of which been reported as histopathological findings of WSN 6 …”

“…5 For this reason, biopsy is often warranted to confirm the diagnosis. 6 However, there is no evidence at this time that WSN develops dysplastic change or causes predilection to cancers of the oral cavity. 5…”

“…While this condition is rare, a correct diagnosis is important to prevent unnecessary treatments and to rule out more concerning or malignant lesions that WSN may mimic 5 . For this reason, biopsy is often warranted to confirm the diagnosis 6 . However, there is no evidence at this time that WSN develops dysplastic change or causes predilection to cancers of the oral cavity 5 …”

“…3 Our patient presented with perinuclear eosinophilic condensations, as well as hyperparakeratosis, acanthosis, and vacuolization of the suprabasal layers, all of which been reported as histopathological findings of WSN. 6 There is no standard of treatment for WSN at present, with most patients not requiring treatment at all or only maintenance of oral hygiene to avoid flares from infection. 2 However, patients have effectively maintained remission through long-term use of systemic low-dose antibiotics.…”

White sponge nevus: A case report of a rare keratinopathy and its novel treatment approach

“…Another report was published by Hegde et al in 2017 [12]. In 2020, Bezerra et al reported cases of WSN demonstrating it as a condition that is not always clinically suspected [13].…”