Papillary Lesions of Oral Mucosa II...Proliferative Verrucous Leukoplakia (PVL) • Elderly •...
Transcript of Papillary Lesions of Oral Mucosa II...Proliferative Verrucous Leukoplakia (PVL) • Elderly •...
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Papillary Lesions of Oral Mucosa II
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Diffuse Papillary and Verrucous Lesions
• Denture Papillary Hyperplasia• Condyloma acuminatum• Focal Epithelial Hyperplasia• Multiple Endocrine Neoplasia III• Proliferative Verrucous Leukoplakia• Acanthosis Nigricans• Focal Dermal Hypoplasia• Keratosis Follicularis
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PapillomatosisInflammatory Papillary Hyperplasia
• Palatal lesions under denture• Extend only within denture
bearing regions• Negative pressure relief zone• Secondary candidiasis• Excision, new denture
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Denture Papillomatosis
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Condylomata
• Multifocal Papillary Lesions• White or coral pink• Intervening normal mucosa• HPV 6, 11• Excision, Laser surgery
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Multifocal Condylomas
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Focal Epithelial Hyperplasia• Childhood, Teen onset• Multiple “fibroma-like” papules• Lips and Buccal Mucosa• Spontaneous resolution 3-12 months• HIV associated condylomas may look
similar to FEH• HPV 13, 32• Mitosoid Viral Inclusions
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Focal Epithelial Hyperplasia (Heck’s Disease)
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Multiple Endocrine Neoplasia III(MEN)
• Pheochromocytoma• Medullary carcinoma of the thyroid• Teen onset• Multiple nodular mucosal neuromas
– Lips– Eyelids
• Mutated gene
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MEN III, Mucosal Neuromas
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MEN III, Neuroma
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Proliferative Verrucous Leukoplakia (PVL)
• Elderly• Females>Males• Alveolar Ridge/Vesibule• Progressive lateral spread over years• A spectrum of histologic variants
– Atypical verrucous hyperplasia– Verrucous carcinoma– Papillary squamous cell carcinoma– Invasive squamous cell carcinoma
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Progressive Temporal Change in PVL
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Proliferative Verrucous Leukoplakia
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PVL, Atypical Verrucous Hyperplasia
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Atypical Verrucous Hyperplasia
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Verrucous Carcinoma• Clinical • Histopathology
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PVL, Papillary Squamous Cell Carcinoma
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Acanthosis Nigricans
• Lips and commisures• Pebbly surface• Variable pigmentation• Two subtypes
– Benign– Malignant (adenocarcinoma, gut)
• Papillomatosis, basilar melanosis
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Acanthosis Nigricans
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Focal Dermal Hypoplasia
• Collagen defect in dermis• Soft fibrous tumors of skin• Papillary lesions of oral mucosa• Strabismus• Mental retardation
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Focal Dermal Hypoplasia
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Keratosis Follicularis (Darier-White disease)
• Defect in keratinization• Orange keratotic papules of skin• Cobblestone appearing lesions of
oral mucosa• Microscopic
– Hyperkeratosis– Acatholysis– Dyskeratosis (corps ronds and grains)
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Keratosis Follicularis