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A Case of Non-hereditary White Sponge Nevus in the Oral Cavity Successfully Treated with Tetracycline Ointment and Oral Multivitamins. J UOEH 2021; 43:421-426. [PMID: 34897171 DOI: 10.7888/juoeh.43.421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
White spongiform nevus is an autosomal dominant inherited disorder first reported by Cannon in 1935. It is a rare disease in which the oral mucosa thickens into an edematous and spongy state and is often accompanied by difficult to recognize subjective symptoms. We report a case of multiple non-hereditary white cavernous nevi in the oral mucosa. The subject was a 22-year-old man with a chief complaint of white lesions in his oral cavity. Examination revealed thick edematous and sponge-like white lesions on the bilateral buccal mucosa, upper and lower lip mucosa, and bilateral lingual margins. There was no history of similar lesions in his family or among his relatives. We diagnosed the case as non-hereditary white sponge nevus, based on clinical and histopathological findings. Although difficult to treat, the lesions disappeared with tetracycline ointment application and oral intake of multiple vitamin supplements. No recurrence of the lesion was observed thereafter.
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Successful Treatment of White Sponge Nevus with Oral Doxycycline: A Case Report and Review of the Literature. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2019.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Sporadic white sponge nevus caused by a mutation in the keratin 4 gene. ORAL AND MAXILLOFACIAL SURGERY CASES 2020. [DOI: 10.1016/j.omsc.2020.100190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Amores-Martín E, Melé-Ninot G, Del Alcázar Viladomiu E, Fernández-Figueras MT. Successful Treatment of White Sponge Nevus With Oral Doxycycline: A Case Report and Review of the Literature. ACTAS DERMO-SIFILIOGRAFICAS 2020; 112:463-466. [PMID: 33220312 DOI: 10.1016/j.ad.2019.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 09/17/2019] [Accepted: 10/05/2019] [Indexed: 10/23/2022] Open
Affiliation(s)
- E Amores-Martín
- Servicio de Dermatología, Hospital Universitari Sagrat Cor, Barcelona, España.
| | - G Melé-Ninot
- Servicio de Dermatología, Hospital Universitari Sagrat Cor, Barcelona, España
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ROKUTANDA S, YAMASHITA K, MORISHITA K, FUJITA S, IKEDA T, UMEDA M. A case of suspected familial white sponge nevus of the oral mucosa. ACTA ACUST UNITED AC 2017. [DOI: 10.5794/jjoms.63.353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Satoshi ROKUTANDA
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences
- Department of Oral and Maxillofacial Surgery, Juko Memorial Nagasaki Hospital
| | - Kentaro YAMASHITA
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences
| | - Kota MORISHITA
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences
| | - Shuichi FUJITA
- Department of Oral Pathology and Bone Metabolism, Nagasaki University Graduate School of Biomedical Sciences
| | - Tohru IKEDA
- Department of Oral Pathology, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences
| | - Masahiro UMEDA
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences
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Abstract
White sponge nevus (WSN) in the oral mucosa is a rare autosomal dominant genetic disease. The involved mucosa is white or greyish, thickened, folded and spongy. The genes associated with WSN include mutant cytokeratin keratin 4 (KRT4) and keratin 13 (KRT13). In recent years, new cases of WSN and associated mutations have been reported. Here, we summarise the recent progress in our understanding of WSN, including clinical reports, genetics, animal models, treatment, pathogenic mechanisms and future directions. Gene-based diagnosis and gene therapy for WSN may become available in the near future and could provide a reference and instruction for treating other KRT-associated diseases.
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Cai W, Chen Z, Jiang B, Yu F, Xu P, Wang M, Wan R, Liu J, Xue Z, Yang J, Liu S, Wang X. Keratin 13 mutations associated with oral white sponge nevus in two Chinese families. Meta Gene 2014; 2:374-83. [PMID: 25606422 PMCID: PMC4287858 DOI: 10.1016/j.mgene.2014.04.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 04/25/2014] [Accepted: 04/25/2014] [Indexed: 01/11/2023] Open
Abstract
White sponge nevus (WSN) is an autosomal dominant hereditary disease. Keratin 4 (KRT4) and Keratin 13 (KRT13) gene mutations were involved in the WSN. We recruited two WSN Chinese families, and oral lesion biopsy with hematoxylin and eosin staining showed that patients had significant pathological characteristics. The mutations of KRT4 and KRT13 gene were detected by PCR and direct sequencing. The multiple alignments of KRT13 from 23 diverse species homology analyses were performed by the ClustalW program. The KRT13 expression was measured by Real-Time RT-PCR and Western blot analysis. Sequencing analysis revealed two mutations of KRT13 gene: one mutation was 332T>C and amino acid change was Leu111Pro. Another mutation was 340C>T and amino acid change was Arg114Cys. The sequence of KRT13 was highly conserved. Real-Time RT-PCR and Western blot analysis results show that KRT13 expression level is lower in patient but keep almost no change in mRNA level. When cells were treated with MG132, KRT13 protein level was increased and kept almost the same in normal and patient cells. We identified two heritable mutations in the KRT13 gene, which were associated with the development of WSN. The abnormal degradation of KRT13 protein of WSN may probably associate with the abnormal ubiquitination process.
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Affiliation(s)
- Wenping Cai
- Translational Center for Stem Cell Research, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, P. R. China
| | - Zhenghu Chen
- Translational Center for Stem Cell Research, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, P. R. China
| | - Beizhan Jiang
- Laboratory of Oral Biomedical Science and Translational Medicine, School of Stomatology, Tongji University, Shanghai 200072, P. R. China
| | - Fang Yu
- Laboratory of Oral Biomedical Science and Translational Medicine, School of Stomatology, Tongji University, Shanghai 200072, P. R. China
| | - Ping Xu
- Laboratory of Oral Biomedical Science and Translational Medicine, School of Stomatology, Tongji University, Shanghai 200072, P. R. China
| | - Mu Wang
- School of Stomatology, Central South University, Xiangya Road, Changsha 410078, P. R. China
| | - Rui Wan
- Translational Center for Stem Cell Research, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, P. R. China
| | - Junjun Liu
- Translational Center for Stem Cell Research, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, P. R. China
| | - Zhigang Xue
- Translational Center for Stem Cell Research, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, P. R. China
| | - Jianhua Yang
- Translational Center for Stem Cell Research, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, P. R. China
| | - Shangfeng Liu
- Translational Center for Stem Cell Research, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, P. R. China
| | - Xiaoping Wang
- Laboratory of Oral Biomedical Science and Translational Medicine, School of Stomatology, Tongji University, Shanghai 200072, P. R. China
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Marrelli M, Tatullo M, Dipalma G, Inchingolo F. Oral infection by Staphylococcus aureus in patients affected by White Sponge Nevus: a description of two cases occurred in the same family. Int J Med Sci 2012; 9:47-50. [PMID: 22211089 PMCID: PMC3222090 DOI: 10.7150/ijms.9.47] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 10/11/2011] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION White Sponge Nevus (WSN) is a rare pathology with a pathogenesis on genetic basis, a benign course and a localization affecting the mucosal keratin.WSN is usually a symptomless pathology: when pain is present, some authors reported reduction of symptoms by taking penicillin or oral tetracycline rinses, suggesting that a bacterial overinfection could be at the base of possible painful symptoms. CASE REPORT We describe 2 patients affected by WSN, father and son: they presented two different oral diseases associated with an infection by Staphylococcus aureus. So, we have performed a careful oral hygiene to reduce infection in the oral cavity. In the following days we prescribed 2 rinses a day with a mouthwash containing chlorhexidine digluconate at two different percentages. DISCUSSION Early diagnosis of this lesion is important, because it allows us to exclude other more serious diseases. In the most part of cases, WSN requires no treatment because of its benign and asymptomatic behaviour: up to now, no protocol of treatment for this condition was standardized. Even if WSN is a painless condition, sometime a correlated painful symptomatology was reported. CONCLUSIONS In our experience, we have achieved excellent results even with chlorhexidine digluconate rinses, considering that our treated cases were both infected by Staphylococcus aureus. We hypothesize that the corrugated plaques and the altered texture of the mucosa create the right conditions for the colonization and the development of microbial species such as saprophytic bacteria or fungal species.
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Affiliation(s)
- Massimo Marrelli
- Department of Oral and Maxillofacial Surgery, Calabrodental, Crotone, Italy
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Elad S, Epstein JB, von Bültzingslöwen I, Drucker S, Tzach R, Yarom N. Topical immunomodulators for management of oral mucosal conditions, a systematic review; part II: miscellaneous agents. Expert Opin Emerg Drugs 2011; 16:183-202. [DOI: 10.1517/14728214.2011.528390] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Aghbali A, Pouralibaba F, Eslami H, Pakdel F, Jamali Z. White sponge nevus: a case report. J Dent Res Dent Clin Dent Prospects 2009; 3:70-2. [PMID: 23230487 PMCID: PMC3517290 DOI: 10.5681/joddd.2009.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Accepted: 04/14/2009] [Indexed: 12/01/2022] Open
Abstract
White sponge nevus (WSN) is a rare hereditary dyskeratotic hyperplasia of mucous membranes. It is an autosomal dominant disorder with variable penetrance. We report a case of WSN in a healthy 21-year-old male with no history of familial involvement. A white smooth plaque with no erythema or other structural abnormalities was observed, which confirmed the diagnosis of WSN histopathologically.
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Affiliation(s)
- Amirala Aghbali
- Assistant Professor, Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Firouz Pouralibaba
- Assistant Professor, Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Eslami
- Post-graduate Student, Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farzaneh Pakdel
- Post-graduate Student, Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Jamali
- Post-graduate Student, Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Abstract
We present an occurrence of white sponge disease affecting four members of the same family: a father and three children. The lesions consisted of white asymptomatic patches in the oral mucosa.
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Martelli H, Pereira SM, Rocha TM, Nogueira dos Santos PLA, Batista de Paula AM, Bonan PRF. White sponge nevus: report of a three-generation family. ACTA ACUST UNITED AC 2007; 103:43-7. [PMID: 17178493 DOI: 10.1016/j.tripleo.2006.05.029] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2005] [Revised: 05/11/2006] [Accepted: 05/26/2006] [Indexed: 11/21/2022]
Abstract
OBJECTIVE White sponge nevus (WSN) is a rare autosomal dominant disorder that results in soft, white, and spongy plaques in the oral mucosa. The aim of this study was to describe the clinical, histopathologic, and genetic features of a family, spanning 3 generations, affected by WSN. STUDY DESIGN This study was performed using a cross-sectional layout analyzing a family with WSN. RESULTS Clinical examination of family members revealed that of 23 descendants, 8 (34.78%) had WSN features. Unaffected and affected members transmitted the disease to their offspring. The offspring recurrence risk was 0.34, and an incomplete level of penetrance was observed. The lesions showed many clinical and histopathologic similarities to cases previously reported. The most affected sites were buccal and labial mucosa, with a rare appearance in the palate. No extraoral lesion was found. Histological examination showed intense acanthosis and hyperparakeratosis-induced epithelial hyperplasia. Within the spinous layer, cells showing perinuclear eosinophilic condensation of the cytokeratin (CK) filaments were frequent. CONCLUSION The disease was transmitted by an autosomal dominant mode of inheritance, appearing mainly in the buccal and labial mucosa.
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Affiliation(s)
- Hercílio Martelli
- Dental Departament, State University of Montes Claros, Minas Gerais, Brazil.
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Polcari I, Chamlin SL. A 6-month-old boy with white oral lesions. Pediatr Ann 2006; 35:874, 876. [PMID: 17236434 DOI: 10.3928/0090-4481-20061201-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Ingrid Polcari
- Division of Pediatric Dermatology, Children's Memorial Medical Center, Northwestern University, Chicago, IL, USA
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Otobe IF, de Sousa SOM, Migliari DA, Matthews RW. Successful treatment with topical tetracycline of oral white sponge nevus occurring in a patient with systemic lupus erythematosus. Int J Dermatol 2006; 45:1130-1. [PMID: 16961540 DOI: 10.1111/j.1365-4632.2006.02922.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Iwánczak F, Barancewicz-Łosek M, Iwánczak B, Kuryszko J, Baran E. Clinical quiz. White sponge nevus. J Pediatr Gastroenterol Nutr 2004; 38:151, 226. [PMID: 14974467 DOI: 10.1097/00005176-200402000-00009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Fanciszek Iwánczak
- IInd Clinic of Pediatrics, Gastroenterology and Nutrition, Medical University Wrocław, Poland
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Chao SC, Tsai YM, Yang MH, Lee JYY. A novel mutation in the keratin 4 gene causing white sponge naevus. Br J Dermatol 2003; 148:1125-8. [PMID: 12828738 DOI: 10.1046/j.1365-2133.2003.05337.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND White sponge naevus (WSN) is a rare, autosomal dominant disorder that predominantly affects noncornified stratified squamous epithelia, most commonly the buccal mucosa. Clinically, WSN manifests as thickened spongy mucosa with a white opalescent tint in the mouth and may be confused with other disorders that cause white lesions on oral mucosa. Recent studies have identified pathogenic mutations in KRT4 and KRT13, the genes encoding mucosa-specific keratins, in WSN. OBJECTIVES To search for possible mutations in KRT4 and KRT13. METHODS We report a case of WSN in a young man who presented with diffuse irregular whitish plaques involving the buccal and gingival mucosae and the tongue. Results Pathologically, the affected mucosa showed epithelial thickening, parakeratosis and extensive vacuolization of the suprabasal keratinocytes. Mutation analysis revealed a heterozygous missense mutation 1345G-->A in KRT4, predicting an amino acid change, E449K, in the 2B domain of the K4 polypeptide. CONCLUSIONS We report the first mutation analysis of a Taiwanese patient with WSN. Potentially this novel mutation could disrupt the stability of keratin filaments and result in WSN.
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Affiliation(s)
- S-C Chao
- Department of Dermatology, National Cheng-Kung University Hospital, 138 Sheng-Li Road, Tainan, Taiwan
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Terrinoni A, Rugg EL, Lane EB, Melino G, Felix DH, Munro CS, McLean WH. A novel mutation in the keratin 13 gene causing oral white sponge nevus. J Dent Res 2001; 80:919-23. [PMID: 11379896 DOI: 10.1177/00220345010800031401] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
White sponge nevus (WSN) is an autosomal-dominantly inherited form of mucosal leukokeratosis. Defects in keratins, proteins that form the stress-bearing cytoskeleton in epithelia, have been shown to cause several epithelial fragility disorders. Recently, mutations in the genes encoding mucosal-specific keratins K4 and K13 were shown to be the underlying cause of WSN. We have studied a large Scottish family with 19 persons affected by WSN in four generations. The K4 locus was excluded by genetic linkage analysis; however, genetic linkage consistent with a K13 defect was obtained. Subsequently, a heterozygous missense mutation 335A>G was detected in exon 1 of the KRT13 gene, predicting the amino acid change N112S in the 1A domain of the K13 polypeptide. The mutation was confirmed in affected family members and was excluded from 50 unaffected people by restriction enzyme analysis. These results confirm that mucosal keratin defects are the cause of WSN.
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Affiliation(s)
- A Terrinoni
- Department of Molecular and Cellular Pathology, University of Dundee, UK
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Lamey PJ, Bolas A, Napier SS, Darwazeh AM, Macdonald DG. Oral white sponge naevus: response to antibiotic therapy. Clin Exp Dermatol 1998; 23:59-63. [PMID: 9692306 DOI: 10.1046/j.1365-2230.1998.00325.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
White sponge naevus is a rare benign inherited disorder of the mucous membranes, principally the oral mucosa. Although the condition is painless, patients are often symptomatic, complaining of an altered texture of the mucosa or that the lesions are unaesthetic. No standard treatment for the condition exists although numerous treatments have been tried. We now report on six patients who were prescribed systemic antibiotic therapy; three were adult men aged 24 years, 32 years, and 52 years, one an 11-year-old woman, one a 6-year-old woman (daughter of the 32-year-old man) and an 18-month-old boy (son of the 24-year-old man). Four responded as judged by clinical examination, although not the 6-year-old female or the 18-month-old male; the discontinuation of therapy then resulted in clinical recurrence in those who had responded, but long-term low dose treatment maintained the remission.
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Affiliation(s)
- P J Lamey
- School of Clinical Dentistry, Queen's University of Belfast, UK
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Abstract
We report a healthy 16-year-old Caucasian boy, who consulted us for white, asymptomatic lesions in the mouth. The lesions were stable and had been present for 6 years. On physical examination, there were diffuse white, soft, corrugated plaques involving the buccal and labial mucosa, oral commissures, and floor of the mouth. No other mucosae were affected and there were no skin or nail abnormalities. The histologic findings revealed epidermal hyperplasia with parakeratosis and intracellular edema in the squamous cell layer. No nuclear atypia was observed. A differential diagnosis of three entities is proposed: white sponge nevus, leukoedema, and focal epithelial hyperplasia.
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Rodriguez-Serna M, Perez A, Febrer I, Botella-Estrada R, Aliaga A. White sponge nevus. Seven cases in the same family. J Eur Acad Dermatol Venereol 1995. [DOI: 10.1111/j.1468-3083.1995.tb00352.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Euvrard S, Kanitakis J, Pouteil-Noble C, Chardonnet Y, Touraine JL, Thivolet J. Pseudo oral hairy leukoplakia in a renal allograft recipient. J Am Acad Dermatol 1994; 30:300-3. [PMID: 8294586 DOI: 10.1016/s0190-9622(94)70027-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Oral hairy leukoplakia (OHL) is a disorder of the tongue associated with Epstein-Barr virus (EBV). OHL is seen mainly in HIV infection but is also rarely seen in the course of iatrogenic immunosuppression, especially in kidney transplantation; OHL is even more rarely seen in immunocompetent hosts. Lesions that clinically and histologically mimicked OHL but were not associated with EBV were recently characterized as pseudo hairy leukoplakia. We present such a case that occurred in a renal allograft recipient; light and electron microscopy, immunohistochemistry, and in situ hybridization were used to examine the patient for the presence of EBV and human papillomavirus. Two independent treatments with topical retinoid and oral amoxicillin resulted in complete remission. Pseudo hairy leukoplakia may correspond, at least in some cases, to the conditions known as leukoedema and white sponge nevus; the distinction of these diseases from OHL is of importance because OHL is a hallmark of severe immunosuppression.
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Affiliation(s)
- S Euvrard
- Department of Dermatology, Hôpital Edouard Herriot, Lyon, France
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