Verruca vulgaris of the tongue

Oral Squamous Papilloma Mimicking Oral Verrucous Leukoplakia

The human papillomavirus (HPV) is a non-enveloped DNA virus that causes a variety of skin and mucosal lesions. This report reviews a likely HPV-related lesion of oral squamous cell papilloma clinically mimicking oral verrucous leukoplakia. A 71-year-old white male presented with a raised white lesion on the palatal mucosa. It felt hard on palpation and had a sessile fixed base, and a rough verrucous surface. The lesion was fully excised. Histopathology showed short, thin, fingerlike projections lined by stratified squamous epithelium with thin central connective tissue cores. The epithelial superficial layers demonstrated focal koilocytotic changes suggestive of an HPV infection. High-risk HPV-related lesions have the potential to turn malignant. Early diagnosis and management are critical to preventing serious complications.

Peripheral Exophytic Oral Lesions: A Clinical Decision Tree

Diagnosis of peripheral oral exophytic lesions might be quite challenging. This review article aimed to introduce a decision tree for oral exophytic lesions according to their clinical features. General search engines and specialized databases including PubMed, PubMed Central, Medline Plus, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of keywords such as “oral soft tissue lesion,” “oral tumor like lesion,” “oral mucosal enlargement,” and “oral exophytic lesion.” Related English-language articles published since 1988 to 2016 in both medical and dental journals were appraised. Upon compilation of data, peripheral oral exophytic lesions were categorized into two major groups according to their surface texture: smooth (mesenchymal or nonsquamous epithelium-originated) and rough (squamous epithelium-originated). Lesions with smooth surface were also categorized into three subgroups according to their general frequency: reactive hyperplastic lesions/inflammatory hyperplasia, salivary gland lesions (nonneoplastic and neoplastic), and mesenchymal lesions (benign and malignant neoplasms). In addition, lesions with rough surface were summarized in six more common lesions. In total, 29 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by a stepwise progression method.

Idiopathic gingival papillokeratosis with crypt formation, a report of 7 cases of a previously undescribed entity: possible unusual oral epithelial nevus?

We report 7 cases of hitherto undescribed keratotic papillary plaques of uncertain etiology involving the gingiva. All 7 cases presented on the anterior maxillary attached gingiva of patients in the second decade. The lesions were asymptomatic and 86% (6 of 7 cases) presented in a bilateral symmetric distribution. Microscopically, the lesions exhibited parakeratosis and papillary acanthosis with parakeratin-filled crypts. No specific etiology such as a factitial habit or a common exogenous agent has been identified. The possibility of a developmental etiology such as an oral epithelial nevus cannot be entirely excluded. We propose the descriptive term idiopathic gingival papillokeratosis with crypt formation (IGPC) for this condition.

Retrospective analysis of benign orofacial tumors at a tertiary referral center in Saudi Arabia

AIM

The aim of the present study was to analyze the prevalence of benign tumors of the orofacial region at a tertiary referral center in the south-western region of Saudi Arabia.

METHODS

Cases from 2009 to 2014 were retrieved from October 2014 to June 2015 from the archives of the histopathology department of the center. Demographic and clinical details of the patients were recorded.

RESULTS

Of the 714 oral and maxillofacial biopsy specimens, 78 (10.9%) were benign tumors. The mean age and range were 34.6±19.8 and 3-85 year, respectively. Sex distribution was equal. Most tumors were mesenchymal (34.6%), followed by epithelial (26.9%), odontogenic (20.5%), and salivary gland tumors (17.9%). Squamous cell papilloma (20.5%) was the most common, followed by pleomorphic adenoma (15.4%) and fibrous tumors (15.4%).

CONCLUSIONS

The low prevalence of benign orofacial tumors found in this study indicates a lack of awareness of the importance of taking biopsy for such lesions. The information reported here emphasizes the need for biopsy investigation for all oral lesions to ascertain appropriate diagnosis.

Viral infections associated with oral cancers and diseases in the context of HIV: a workshop report

Human herpesviruses (HHVs) and human papillomavirus (HPV) are common in the general population and, in immunocompetent people, are mostly carried asymptomatically. However, once an individual becomes immunocompromised by age, illness or HIV infection these dormant viruses can manifest and produce disease. In HIV-positive patients, there is an increased risk of disease caused by HHVs and HPV infections and cancers caused by the oncoviruses Epstein-Barr Virus, HHV-8 and HPV. This workshop examined four questions regarding the viruses associated with oral cancers and disease in the HIV-positive and -negative populations, the immune response, and biomarkers useful for accurate diagnostics of these infections and their sequalae. Each presenter identified a number of key areas where further research is required.

Oral Human Papillomavirus Infection in Children

Oral human papillomavirus infection is rare in children, but the presence of a villous lesion with slow but continuous growth concerns parents, who need information and therapeutic solutions from the physician. All these aspects are discussed based on a case report of a 9-year-old child with an oral human papillomavirus infection.

Human papillomavirus infection in the oromaxillofacial area: Clinical anatomy and histological considerations

Clinical manifestations of human papillomavirus (HPV) infection in the head and neck can range from benign lesions, which are the most frequent, to malignant lesions. The prevalence of head and neck cancer is increasing, despite currently decreasing trends in known risk factors such as smoking and alcohol use. A new patient profile has appeared in recent practice: most frequently a middle-aged male patient who does not smoke or drink alcohol, is sexually active (possibly having multiple partners), and presents with oral or cervicofacial lesions requiring diagnosis and treatment. Another risk factor that should be considered in these patients is HPV infection. The association of oral potentially malignant disorders (OPMD) with HPV is a challenge for the medical practitioner. The gold standard for diagnosis is histopathological examination, which can also yield evidence suggesting HPV infection. Determination of the viral genotype provides additional data for assessing the oncological risk of an HPV infection. Treatment of these patients is aimed at removing the lesions, in association or not with antiviral treatment and recurrence control.

Verruca vulgaris of the tongue: a case report with a literature review

Verruca vulgaris (common warts) is a benign lesion of skin and mucous membranes caused by human papillomavirus (HPV). The lesions are typically self-limited but may vary in size and number. The occurrence on the tongue is extremely rare. To the best of our knowledge, only one verruca vulgaris existing in the tongue had been reported in the literature.

CASE PRESENTATION

A rare case of verruca vulgaris of the tongue occurring in a 36-year-old Caucasian male is presented with a discussion on ethiopathogenesis and the treatment methods. Verruca vulgaris must be remembered in the differential diagnosis of tongue lesions and surgical treatment may provide satisfactory outcomes.