Benign Epithelial Pathology

2.  Etiology: Human Papilloma Virus 6 and 11
 Clinical Features:
› Any age – 30 to 50 years
› On tongue, lips and soft palate
› Soft , painless, pedunculated, exophytic
nodule with projections
› Cauliflower or wartlike appearance

3.  Histopathologic Features:
› Proliferation of keratinised stratified
squamous epithelium
› Fibrovascular tissue cores
Squamous
papilloma on
lateral border of
tongue

4.  Koilocytes – virus altered epithelial cellls
with pyknotic nuclei
 Treatment : Conservative surgical
excision

5.  Known as common wart
 Etiology : HPV 2,4,6 and 40
 Clinical Features:
› Contagious
› Commmon in children and on skin
› Painless nodule with papillary projections
› Rough pebbly surface
› Extreme accumulation lead to keratin horn

6.  Histopathologic Features:
› Hyperkeratotic stratified squamous
epithelium in finger like projections
› Koilocytes are present in epithelium

7.  Treatment:
› Liquid nitrogen cryotherapy
› Surgical excision or curettage
› Laser
› Keratinolytic agents – salicylic acid

8.  Known as self healing carcinoma
 Etiology:
› Trauma
› Sunlight
› HPV 9,11,13,16,18,24,33,37,57
› Immunocompromised state

9.  Clinical Features:
› More in men
› On sun exposed area of face- vermillion
border of lips
› Dome shaped nodules with keratin plug
projecting like a horn
› Painful

10.  Histopathologic Features:
› Hyperplastic squamous proliferation
› Dyskeratosis
› Epithelium at the base proliferate
downwards
› Produces chronic inflammatory response
 Treatment :
› Surgical excision

11.  Known as snuff dipper’s lesion
 Etiology:
› Chewing or holding finely ground tobacco
leaves in vestibule
 Clinical Features:
› Painless loss of gingival and periodontium in
area of contact
› Destruction of alveolar bone
› Brown-black stains

12.  Wear of incisal and occlusal surfaces
 Thin gray or gray-white plaque
 Velvety feel of mucosa
 Stretched mucosa appears fissured

13.  Histopathologic Features:
› Intracellular vacuolization of superficial cells
› Parakeratin chevrons as pointed projections
› Hyperkeratosis and acanthosis

14.  Treatment:
› Cessation of habit leads to normal mucosa
appearance
› Takes 2 to 6 weeks to regress

15.  Known as farmer’s lip and sailor’s lip
 Etiology:
› Long term exposure to UV light
› Light skinned people
 Clinical Features:
› Males more
› Lower lip vermillion
› Smooth surface and blotchy pale areas

16.  Progress to rough scaly areas
 Chronic focal ulceration at places of
trauma

17.  Histopathologic Features:
› Atrophic stratified squamous epithelium
› Connective tissue shows band of
amorphous, acellular basophilic change
(solar elastosis)
 Treatment :
› Use lip balms with
sunscreen
› Vermillionectomy
› CO2 laser ablation
› Electrodessication

18.  Known as Heck’s disease
 Etiology :
› HPV 13 and 32
 Clinical Features:
› Primarily in children
› Papillary lesion
› Smooth surfaced flat topped lesion
› Well demarcated

19.  Cluster to form cobblestone
appearance or fissured appearance

20.  Histopathologic Features:
› Focal acanthosis
› Epithelial show koilocytic change
› Cells with collapsed nuclei – mitosoid cells
› Lack of connective tissue cores in surface
projections
 Treatment :
› Excision

21.  Known as smoker’s palate
 Etiology:
› Cigar and pipe smoking
› Reverse smoking
 Clinical Features:
› More in men
› Palatal mucosa – diffusely gray or white
› Elevated papules with punctate red centers

22.  Fissured or dried mud appearance
 Brown or black stain on teeth

23.  Histopathologic Features:
› Hyperkeratosis and acanthosis
› Inflammation of connective tissue
› Metaplasia of excretory ducts
 Treatment :
› Smoking cessation
leads to regression

24.  WHO - “a white patch or plaque that
cannot be characterised clinically or
pathologically as any other disease”
 Premalignant lesion – benign
morphologically altered tissue that has a
greater than normal risk of malignant
transformation

25.  Etiology:
› Tobacco smoking
› Alcohol consumption
› UV radiation
› Sanguinaria – toothpaste containing herbal
extract
› Microorganism - treponema pallidum
› Trauma
 Clinical features:
› Older people - 40 years
› On lip vermillion , buccal mucosa, gingiva ,
tongue

26.  Slightly elevated gray or gray white
plaques
 Plaques are fissured, wrinkled and
sharply demarcated
 Maybe be intermixed red-and-white
lesion-erythroplakia

27.  Histopathologic Features:
› Thickened surface keratin layer or thickened
spinous layer which masks redness of
underlying connective tissue
› Hyperkeratosis with acanthosis
› Dysplastic features

28.  Treatment:
› Surgical excision
› Electrocautery
› Cryosurgery
› Laser ablation
› Cessation of smoking
› Retinoids

29.  It is a red patch that cannot be clinically
or pathologically diagnosed as any
other condition
 Clinical Features:
› Well demarcated
erythematous macule
or papule
› Soft velvety texture

30.  Histopathologic Features:
› Epithelial dysplasia
› Epithelium show lack of keratin production
› Atrophic epithelium
› Thus red color
 Treatment:
› Irritation source removed
› Biopsy to confirm diagnosis