frictional keratosis on tongue

In most cases, oral frictional keratosis appears as a thin line that is white in color across the cheek opposite the meeting point of the teeth. [QxMD MEDLINE Link]. Br J Oral Maxillofac Surg. 4b). Linea alba is thought to result from chronic cheek biting or sucking of these tissues (see images below). Cifuentes M, Davari P, Rogers III RS. Perivascular inflammation in the deeper lamina propria is present, a feature not typical for oral lichen planus (H&E magnification 40). A review of the prior biopsy of the affected mucosa revealed an irregularly hyperplastic epithelium with foci of ballooned epithelial cells within the upper layer, parakeratosis, and bacterial overgrowth (Figure 2). A patient may notice a thickening or roughness of the involved mucosal site, or frictional keratosis may be discovered as an incidental finding during a routine oral examination. Low-power view of stratified squamous epithelium with marked hyperkeratinization, acanthosis, and a prominent granular cell layer. Larsson A, Axll T, Andersson G. Reversibility of snuff dippers lesion in Swedish moist snuff users: a clinical and histologic follow-up study. White, thickened plaques with irregular, rough surface change are noted on the gingiva of the right maxilla and mandible. Scope of practice, referral patterns and lesion occurrence of an oral medicine service in Australia. McParland H, Warnakulasuriya S. Oral lichenoid contact lesions to mercury and dental amalgama review. Frictional keratosis from the alveolar ridge usually is surfaced by orthokeratin with a slightly irregular or corrugated architecture (Fig. 1c Interface mucositis in amalgam contact reactions are seen and the dense lymphocytic infiltrate can form tertiary follicles (arrow) (H&E magnification 100). Leukoplakia of gingiva, lips, tongue. Br Dent J. [QxMD MEDLINE Link]. Leukoedema affects the bilateral buccal and labial mucosa and appears as an opalescent, filmy gray to white lesion that characteristically diminishes upon stretching of the mucosa (Fig. Clipboard, Search History, and several other advanced features are temporarily unavailable. Bouquot JE, Gorlin RJ. These white patches in the mouth only disappear when the source of friction is removed. Federal government websites often end in .gov or .mil. Frictional keratosis typically occurs on the lateral borders of the tongue as a consequence of tongue biting by the molar teeth or some other abrasive irritant (eg, from rubbing upon poorly fitting dental work), as shown in the image below. Frictional keratosis Frictional keratoses occur in oral cavity subsites that are subjected to chronic low-grade trauma. The A systematic review. 73(6):708-16. Tex Dent J. The retromolar pad and edentulous alveolar ridge can exhibit benign keratosis as the area is susceptible to both masticatory forces, occlusal trauma or ill-fitting dentures or other dental appliances (Fig. Rounded or irregularly shaped white plaques may be seen on the anterior dorsal surface of the tongue from a chronic tongue thrust habit (tongue thrust keratosis, Fig. The use of oral tobacco products used in North American and Europe can result in clinical changes at the site of tobacco placement. Biopsies should be performed on these lesions that do not heal to rule out a Frictional keratosis. This causes irritation to the gum and cheek in the mouth. 7-1b) [26, 28]. In one patient, the surface of the last molar tooth showed considerable occlusal wear, which is evidence that the patient had the habit of grinding his teeth (see first image above). The https:// ensures that you are connecting to the Differentiating between frictional keratosis and lesions from smoking or smokeless tobacco is of utmost important given that their prognoses is different from that of the typical frictional keratosis. Tongue lacerations can also result in scarring or swelling. Case of the month. A 55-year-old man presented with desquamating lesions on his bilateral buccal mucosa intermittently for approximately 3 years. Smoker's keratosis - Pipe smoking is the usual cause. This wider area of roughened mucosa is typical of those produced by the habit of cheek biting or nibbling. These lesions can occasionally mimic dysplastic leukoplakia. Tuberculosis of the oral cavity: a case report. The plaque had a slightly irregular surface, had no surrounding erythema, and was the only such plaque in the . When the gingival tissues are involved, patients may report using a medium- or hard-bristled toothbrush or other oral hygiene aids. This website also contains material copyrighted by 3rd parties. In some patients the frictional keratoses can be extensive involving the entire cheek and extending to the lips. Share cases and questions with Physicians on Medscape consult. External factors that mostly cause frictional keratosis are through smoking though that occurs mostly in lips. 1986 Apr. Clin Prev Dent. The lesions resolve after discontinuing the suspected product. Meta-analysis of the relation between European and American smokeless tobacco and oral cancer. The surface can feel rough with irregular tags which initiates a cycle of a patient removing the rough tags with their teeth only to produce more tags. The white patches or thickening associated with constant friction or bites that gradually damage the lining of ones moth, tongue, the gums, palate, lips, teeth and so on. Coleman GC, Flaitz CM, Vincent SD. The white line shows a slightly scalloped appearance, which correlates with the buccal surfaces of the teeth against which the mucosa is rubbed. A thicker patch of mucosa is at the anterior end (under the tongue blade edge). However, there are instances when the leukoplakia may . [QxMD MEDLINE Link]. HHS Vulnerability Disclosure, Help 3rd ed. [4] The formation rate depends on the frequency of habit, dose, and even the brand used. The true prevalence of frictional keratoses is unknown as studies that review oral mucosal lesions are generally clinically based and may miscategorize leukoplakia as frictional keratoses or vice versa. The true prevalence of frictional keratoses is unknown as studies that review oral mucosal lesions are generally clinically based and may miscategorize leukoplakia as frictional keratoses or vice versa. Ask one of your family member to evaluate if you grind . Snuff-dippers lesion. These include frictional keratosis arising from excessive force while brushing the teeth (toothbrush keratosis); the constant rubbing of the tongue against the teeth (tongue thrust keratosis); the constant sucking, pressure, and irritation of the teeth against the buccal mucosa along the plane of occlusion (linea alba); and the habit of chronic cheek, tongue, or lip biting (cheek- or lip-bite keratosis). It is, however, more common in younger patients. Weitkunat R, Sanders E, Lee PN. Geographic It is seen worldwide. 19(2):99-103. Eczema is also called dermatitis. 2009 Jan;67(1):140-6. doi: 10.1016/j.joms.2008.08.040. a Superficial sloughing of the oral mucosa due to the use of triclosan and pyrophosphate containing toothpaste. 2006 Nov. 12(6):553-8. It was concluded that the hyperkeratosis was likely caused by bite trauma or grinding of the teeth while the patient was asleep. Toothbrush trauma is often cited as the etiology of keratotic lesions of the gingiva. Diagnosis : Geographic Tongue (Erythema Migrans) Diagnosis Banding : Erythematous Candidiasis, Lichen Planus, Lupus Erythematosus, dan Leukoplakia 4. Mller S. Oral epithelial dysplasia, atypical verrucous lesions and oral potentially malignant disorders: focus on histopathology. . Evidence-based clinical recommendations regarding screening for oral squamous cell carcinomas. Oral Dis. In some individuals who repeatedly traumatize the tissues, tenderness, swelling, and a burning sensation may be presenting symptoms. Bacterial colonies are present on the keratin surface without an inflammatory response (H&E, magnification 100). Both triclosan, an antimicrobial agent, and sodium pyrophosphate are added to toothpaste either as a single ingredient or combined in tartar-control toothpaste to prevent plaque development. Frictional Keratosis. Community Dent Oral Epidemiol. 7 Oral frictional keratosis lesions typically reduce or resolve . Toothpaste-related oral lesions. This review will focus exclusively on reactive white oral lesions. If you notice a spot on your skin that looks red, feels rough & will not heal, what you Privacy Policy | Security Statement | Terms & Conditions. This is the American ICD-10-CM version of K13.21 - other international versions of ICD-10 K13.21 may differ. High-power view of the surface keratin layer and a prominent granular cell layer. The first step in the identification of white patches suspected of being associated with physical trauma is to use a 2 X 2-inch sterile gauze to wipe off the lesion or lesions. It is possible to treat pigmentation yourself at home. Erythema and ulceration may be present. Triamcinolone 0.1% ointment in Orabase and tretinoin 0.05% gel were ineffective. Frictional keratosis can also be avoided in a number of ways. [QxMD MEDLINE Link]. Flaitz CM. 1 d). You are being redirected to Oral contact lesions to amalgam dental restorations can present as a keratotic or lichenoid lesion (Fig. [QxMD MEDLINE Link]. With progression the lesions become more keratotic with furrowing of the epithelium and thickening (Fig. Castellanos JL, Daz-Guzmn L. Lesions of the oral mucosa: an epidemiological study of 23785 Mexican patients. Inset: High-power photomicrograph highlights the dyskeratotic cells which have crenated or pyknotic nuclei surrounded by dense hypereosinophilic cytoplasm giving the appearance of intraepithelial dyskeratosis. The white patch that is the greatest sign of oral frictional keratosis is caused by the constant friction on the soft tissues in the mouth. SLS is a common synthetic detergent added to toothpaste for foaming and cleaning. Systematic review of the relation between smokeless tobacco and cancer in Europe and North America. These deposits can be seen around nerves, vessels, salivary glands, and at the epithelial-stroma interface. [20] Occasionally, ill-fitting or broken mouthguards or occlusal splints irritate the oral mucosa, resulting in frictional keratosis. 2008 Jan. 58(1):151-7. These plaques are moveable over the underlying tissue. Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS. Introduction. 6b) [24]. sharing sensitive information, make sure youre on a federal Epub 2019 Jan 22. de Aguiar MC, Arrais MJ, Mato MJ, de Arajo VC. Chi AC, Lambert PR, 3rd, Pan Y, Li R, Vo DT, Edwards E, Gangarosa P, Neville BW. When the inflammation is difficult to control, chronic eczema can lead to: Hyperkeratosis. 141(5):509-20. 119(6):484-8, 490-2, 494-503. [QxMD MEDLINE Link]. This material is negative for Congo red and positive with periodic acid-Schiff confirming the collagen nature [36]. Natarajan E, Woo SB. Cai W, Jiang B, Yu F, Yang J, Chen Z, Liu J, Wei R, Zhao S, Wang X, Liu S. Current approaches to the diagnosis and treatment of white sponge nevus. Most patients with frictional keratosis are free of symptoms, with the exception of those with aggressive cheek and lip biting habits. This finding can be best appreciated on exfoliative cytology with Papanicolaou staining (Fig. FRICTIONAL KERATOSIS White lesions caused by repeated trauma, such as from food, the teeth, toothbrushing or dental appliances. 4b inset). The white area on your tongue could mostly be due to friction which causes Frictional keratosis. Within the parakeratin and spinous layer, are dyskeratotic cells with crenated or pyknotic nuclei surrounded by homogenously dense eosinophilic cytoplasm (Fig. The patient found that rinsing with hydrogen peroxide solution was most helpful in reducing the lesions. Unable to load your collection due to an error, Unable to load your delegates due to an error. Normal variations of oral anatomy and common oral soft tissue lesions: evaluation and management. Sometimes it is extremely difficult to read the symptoms of frictional keratosis until after you start feeling pain. Eczema causes itching, redness and tiny blisters. They include: The list can go on and on. Linea alba is the term used to describe the white keratotic line on the buccal mucosa approximating the occlusal plane. INCIDENCE Frictional keratosis is common. Amalgam reactions are generally considered type IV hypersensitivity reactions [26]. Similar to frictional keratosis of the buccal mucosa and tongue, a paucity of inflammatory cells is present. They therefore do not need treatment as they often disappear after sometime unless the affected area is rubbed against repeatedly. However, using clinical features to classify lesions is difficult because they vary in appearance and are likely to be interpreted subjectively by the clinician. Frictional keratosis is a skin growth that can result from mild mechanical trauma or irritation of the skin. Forceful or aberrant nutritional sucking on the nipple of the bottle or breast may result in calluses on the lips of infants. It seems to grow pretty steadily. The clinical findings can be of an ill-defined area of gray or white papules and plaques and may be associated with erosions and ulcers if the bite trauma is extensive. An official website of the United States government. Early PVL lesions from the alveolar ridge and gingiva are indistinguishable from benign keratosis and leukoplakia without dysplasia exhibiting marked orthokeratosis with a slight corrugated surface and prominent granular cell layer (Fig. The abovementioned categories of frictional keratosis should inform you that you need to be careful when you are brushing, for instance, so that you do not cause damage to your mouth and create a condition that will come to haunt you the rest of your life. Frictional keratosis typically occurs on the lateral borders of the tongue as a consequence of tongue biting by the molar teeth or some other abrasive irritant (eg, from rubbing upon poorly . 2000 Nov-Dec. 22(6):511-2. [QxMD MEDLINE Link]. Kovac-Kovacic M, Skaleric U. a Leukoedema of the left buccal mucosa in a 58-year-old Black female presenting as an ill-defined opalescent filmy gray to white lesion. Microscopic examination of fragments of mucosa peeled away from the affected area revealed fragments ofparakeratotic cornified material colonized by numerous bacteria (Figure 3). It could also arise from excess deposit of keratin due to a process called hyperkeratinization. This is particularly true when the lesion presents on the lateral border of the tongue, which is the most common location for oral cavity squamous cell carcinoma [7]. St. Louis, Mo: WB Saunders; 2009. The clinical findings are critical in helping to distinguish between reactive keratosis and OPMD. (cold sores), the gums, the tongue, the palate (roof of mouth) or the tongue. Prevalence of oral mucosal lesions in a Kenyan population with special reference to oral leukoplakia. The diagnosis of oral frictional hyperkeratosis was established based on the clinical and microscopic findings. Without appropriate clinical information these lesions should be diagnosed not as frictional keratoses but as keratoses without dysplasia or as keratosis of unknown significance [13]. I'm hoping it's some sort of frictional keratosis but I'm not aware of me doing . Mller S. Frictional keratosis, contact keratosis and smokeless tobacco keratosis: features of reactive white lesions of the oral mucosa. Most epidemiologic studies in North America and Europe show a minor increased risk of oral cancer [33, 39, 40]. Linea alba can present unilateral or bilateral and varies in color intensity and thickness [4, 5]. In most STK, no epithelial dysplasia is identified although the basal layer nuclei may be hyperchromatic. WSN is inherited as an autosomal dominant trait that presents as asymptomatic thickened soft white plaques most commonly on the buccal mucosa (Fig. Accessibility The whiteness is as a result of more cells being set by the body as it reacts to the irritation caused by friction. Frictional keratosis presents as a white lesion (macule or plaque) determined by repeatedly trauma, in turn caused by particularly sharp dentures, ill-fitting dentures or poor oral habits (e.g. 15(2):89-97. 30100 Telegraph Road, Suite 408, Bingham Farms, Michigan 48025 (USA) Hyperkeratotic lesions, although very common in the forestomach, are rare on the tongue in NTP studies. The . leukoplakia), or malignancy (e.g. White lesions in oral cavity Def. Endo H, Rees TD. The 2022 edition of ICD-10-CM K13.29 became effective on October 1, 2021. HBID does not affect the anogenital region, esophagus or nasal mucosa. 2000. An official website of the United States government. Although candidal hyphae may be present this is uncommon and unrelated to the underlying etiology. However, if lesions persist, complete removal is advisable. I have frictional keratosis under my tongue. Changing trends in oral squamous cell carcinoma with particular reference to young patients: 19712006. 1980. The fact that the skin condition Several methods had been developed for the effective removal of senile warts. Scattered throughout the epithelium but most appreciated in the upper spinous layer are dyskeratotic cells. 2:21-4. 2a Oral lichenoid contact reaction of the right buccal mucosa to cinnamon flavored chewing gum. However, there are instances where the etiology is unknown, or the keratotic lesion is in a high-risk area for OPMDs. Cam K, Santoro A, Lee JB. Its affecting many people both kids and even the Seborrheic keratosis can come up in the form of bumps on the skin. Cinnamon is used a wide array of products such as toothpaste, mouthwash, gum, candy and soft drinks. frictional keratosis), an oral potentially malignant disorder (e.g. Jones KB, Jordan R. White lesions in the oral cavity: clinical presentation, diagnosis, and treatment. from habit of pushing tongue against teeth. Woo SB, Grammer RL, Lerman MA. Frictional hyperkeratosis. Jose Luis Tapia, DDS is a member of the following medical societies: American Academy of Oral and Maxillofacial PathologyDisclosure: Nothing to disclose. It started off as one small white area at the beginning of January and the 2nd pic is today. Frictional keratosis from the alveolar ridge usually is surfaced by orthokeratin with a slightly irregular or corrugated architecture (Fig. Frictional keratosis is among the many different keratosis conditions. Madani FM, Kuperstein AS. 8c) [32, 35, 36]. It might have already appeared on you Privacy Policy | Security Statement | Terms & Conditions, Seborrheic Keratosis Removal With Hydrogen Peroxide, Home Remedy For Removing Seborrheic Keratosis, Herbal Treatment For Seborrheic Keratosis. Mathew AL, Pai KM, Sholapurkar AA, Vengal M. The prevalence of oral mucosal lesions in patients visiting a dental school in Southern India. The collagen sclerosis can be concentrated around nerves, vascular channels and can also result in salivary gland fibrosis. Various names have been used to describe particular examples of frictional keratosis (FK). 2005 Nov 12. Leukoplakia is a clinical term reserved for white lesions that cannot be characterized clinically or pathologically as any other disease (ie, frictional keratosis, lichen planus, candidiasis,. 1 A fractured tooth or rough restoration may lead to the development of frictional keratosis on the adjacent lateral tongue or buccal mucosa. This may also be seen on vestibular mucosa in areas where loose dentures chronically and mildly push against the mucosa. Lesions associated with a tongue thrusting habit often demonstrate prominent crenations of the lateral tongue. Case number 3. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTA3NjA4OS1jbGluaWNhbA==. Martelli H, Jr, Pereira SM, Rocha TM, Nogueira dos Santos PL, Batista de Paula AM, Bonan PR. It occurs as a white patch in the mouth. J Oral Pathol Med. b Photomicrograph demonstrates marked parakeratosis, acanthosis and intracellular edema. Oral Dis. In addition to these ingredients, flavoring agents are added to mask the bitter taste of pyrophosphate. Two rare genodermatoses that can have clinical overlap with frictional keratoses but have distinct histologic features are white sponge nevus (WSN) and hereditary benign intraepithelial dyskeratosis (HBID). Prevalence of oral lesions in 13- to 16-year-old students in Duzce, Turkey. Farah CS, Simanovic B, Savage NW. 2007 Sep 22. Woo SB, Lin D. Morsicatio mucosae orisa chronic oral frictional keratosis, not a leukoplakia. What is white sponge nevus? The cause of the patches . Bookshelf In one study evaluating benign alveolar ridge keratosis with lesions exhibiting dysplasia, lesional size was not a predictor [10]. In addition to PVL there are benign conditions that can have clinical overlap with frictional keratosis. Another histologic feature present in amalgam contact reactions and not a typical finding in oral lichen planus is the presence of a deep inflammatory infiltrate rather than inflammation confined to the lamina propria subjacent to the epithelial basal cells. In some individuals certain dentifrices can result in superficial sloughing of the oral mucosa (Fig. PREDISPOSING FACTORS The plaques could be easily peeled away from the underlying skin with a cotton swab without any pain, leaving behind normal underlying mucosa. The corresponding tooth can be slightly recontoured and polished. It can also lead to serious complications and timely diagnosis and treatment is necessary. a Irregular, shaggy macerated appearance of the left buccal mucosa typical for cheek biting (morsicatio mucosae). Care should be made in rendering a diagnosis of frictional keratosis of the alveolar ridge and more importantly, gingiva in tooth-bearing areas when limited clinical information is available. Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS. [QxMD MEDLINE Link]. Pentenero M, Meleti M, Vescovi P, Gandolfo S. Oral proliferative verrucous leucoplakia: are there particular features for such an ambiguous entity? Leukoplakia is a patch that is white to gray in color. will also be available for a limited time. These microscopic features are not unique to dentifrice stomatitis, but with appropriate clinical information, an association can be proffered. This histology is virtually indistinguishable from ridge keratosis (Fig. In the recent WHO (2017), squamous cell hyperplasia has been omitted as an OPMD [1]. The buccal mucosa and vestibule are usually affected, and the appearance is of white strings easily removed with a finger without leaving any ulceration or erythema [2125]. Such keratosis conditions as oral frictional keratosis do not affect ones health to a great extent. 1 d). Nonetheless, this condition should be treated during its initial stages to achieve best results. At times the superficial parakeratin is completely detached from the underlying stratified squamous epithelium or this superficial sloughing is all that is submitted for histologic examination. PMC 13 (1):16-24. See your doctor if the lesions become chronic and painful. 1992 Jun. A persons mouth is one of the most sensitive and important parts of the human body and should therefore be protected from any form of friction or irritation that has potential to cause frictional keratosis. Br Dent J. 1d). c Photomicrograph of smokeless tobacco keratosis shows a corrugated parakeratotic surface and epithelial acanthosis. Catherine M Flaitz, DDS, MS Professor of Oral and Maxillofacial Pathology and Pediatric Dentistry, Department of Diagnostic and Biomedical Sciences, University of Texas Health Sciences Center at Houston School of Dentistry, Catherine M Flaitz, DDS, MS is a member of the following medical societies: American Academy of Oral and Maxillofacial Pathology, American Academy of Oral Medicine, American Academy of Pediatric Dentistry, American Dental Association, International Association for Dental Research, and International Association of Oral Pathologists, Disclosure: Trimira, LLC Clinical contract for study Co-investigator on clinical grant; Trimira, LLC Honoraria Speaking and teaching; GC America Clinical contract for study Co-investigator on clinical grant; Forward Science LLC Device evaluation Product evaluation for school use. 7 The characteristic white appearance of oral frictional keratosis is due to generation of keratin filaments from chronic irritation. Seborrheic keratosis can affect just about any part of the body but, through studies and a lot of research Seborrheic Keratosis is one the most common skin diseases today. d Histopathologic features of ridge keratosis characterized by marked hyperorthokeratosis, hypergranulosis and acanthosis. This involves removal of the agent that causes irritation on the cheeks, lips and gum. Products with strong and independent risk factors for oral cancer prevalent in Southeast Asia such as betel quid, gutka, paan and others, some which do not contain tobacco will not be discussed here [34]. Snuff dippers keratosis or snuff pouch. Type 1 Excludes. [QxMD MEDLINE Link]. Benign alveolar ridge keratosis (oral lichen simplex chronicus): A distinct clinicopathologic entity. a Clinical features of proliferative verrucous leukoplakia in a 76-year-old non-smoking female. Kashani HG, Mackenzie IC, Kerber PE. Note the lack of inflammation (H&E, magnification 100). Frictional Keratosis. 10(2):114-5. Frictional keratosis, though, is not in the same category as dysplasia. 2002 Jan-Feb. 7(1):4-9, 10-6. Kowitz G, Jacobson J, Meng Z, Lucatorto F. The effects of tartar-control toothpaste on the oral soft tissues. The lesions usually present on the buccal mucosa or tongue where prolonged contact of the mucosa with the amalgam occur. Smokeless tobacco keratosis is caused by constant frictional irritation of smokeless tobacco against the oral mucosa resulting in keratosis. Its appearance can also be in form of a distinct patch that is also white in color in any part in the mouth. It may affect any area of the mouth such as the tongue, roof of the mouth, gums and the insides of the cheek.

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