Oral frictional hyperkeratosis - Oral Mucosal Lesion
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Synopsis

Oral frictional hyperkeratosis is a benign white lesion of the oral mucosa that is caused by chronic trauma to the site. This tends to occur in adults.
The area is asymptomatic.
This occurs on the maxillary and mandibular alveolar ridges particularly after extraction of teeth, and particularly in the area of extracted mandibular third molars on the retromolar pad area. The alveolar ridge mucosa that had previously been "protected" from food impingement is now exposed to trauma and becomes hyperkeratotic as a protective mechanism.
However, other sites may be affected depending on the circumstance. For example, a sharp or broken cusp that rubs against the buccal mucosa or lateral/ventral tongue may cause an area of hyperkeratosis.
These areas take months to develop and they persist as long as the traumatic events persist.
Related topic: Chronic cheek chewing
The area is asymptomatic.
This occurs on the maxillary and mandibular alveolar ridges particularly after extraction of teeth, and particularly in the area of extracted mandibular third molars on the retromolar pad area. The alveolar ridge mucosa that had previously been "protected" from food impingement is now exposed to trauma and becomes hyperkeratotic as a protective mechanism.
However, other sites may be affected depending on the circumstance. For example, a sharp or broken cusp that rubs against the buccal mucosa or lateral/ventral tongue may cause an area of hyperkeratosis.
These areas take months to develop and they persist as long as the traumatic events persist.
Related topic: Chronic cheek chewing
Codes
ICD10CM:
K13.79 – Other lesions of oral mucosa
SNOMEDCT:
235034000 – Oral frictional keratosis
K13.79 – Other lesions of oral mucosa
SNOMEDCT:
235034000 – Oral frictional keratosis
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Leukoplakia – This is the most important differential diagnosis. Because of the premalignant and malignant connotation of leukoplakia, and if you are in doubt, a biopsy should be undertaken.
- Linea alba –This is a form of frictional keratosis seen on the buccal mucosa with a characteristic clinical appearance.
- Chronic cheek chewing (bite injury) – This is another form of frictional keratosis that has a shaggy surface configuration.
- Candidiasis – This is usually acute, tends to be surrounded by erythema, and is usually multifocal in presentation.
- Lichen planus
- Squamous cell carcinoma
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Last Updated:06/10/2018