Benign oral epithelial

• Benign oral epithelial lesions associated with human papilloma virus

  • Squamous cell papilloma
  • Verruca vulgaris (common wart)
  • Condyloma acuminatum (venereal wart)
  • Focal epithelial hyperplasia (Hecks disease)
  • Sinonasal papilloma
  • Molluscum contagiosum
  • Veriform xanthoma
• Types of melanocytic nevus

  • Acquired melanocytic nevus
  • Congenital melanocytic nevus
  • Halo nevus
  • Blue nevus
• Squamous cell papilloma


  A benign neoplasm derived from oral epithelium
• Squamous cell carcinoma


  A malignant neoplasm derived from oral epithelium
• Basal cell carcinoma does not occur in the oral cavity but may present on the lip and involve the vermilion border
• Human papilloma virus (HPV)


  DNA viruses, more than 75 types recognized, at least 16 isolated from oral lesions
• Low-risk HPV types


  e.g. 6, 11, 13, and 32, associated with benign lesions of the skin and oral mucosa
• Identification of HPV in a lesion does not necessarily imply a causal relationship
• Squamous cell papilloma


  A benign epithelial proliferation, HPV is found in most cases, especially HPV 6 and 11
• Squamous cell papilloma


  • Exophytic, papillary mass, less than 1 cm
  • Usually pedunculated and soft in texture
  • White
  • Usually solitary, may be multiple
  • Favors soft palate, uvula, tongue, gingiva, buccal mucosa
• Verruca vulgaris (common wart)

  Infection of mucosal epithelium by HPV, usually HPV 2, 4, 6, or 11
• Verruca vulgaris


  • Papular to nodular and exophytic appearance
  • Surface texture is cauliflower-like or verruciform
  • Perioral skin lesions may be brownish, oral mucosal lesions are usually white to pink
  • May be pedunculated or broad based
  • Intraoral sites of predilection include lips, palate, and attached gingiva
  • Multiple oral lesions may be evident in immunocompromised patients
• Condyloma acuminatum (venereal wart)


  A sexually transmitted disease associated with HPV types 6, 11, 16, and 18
• Condyloma acuminatum


  • Usually on nonkeratinized tissues in immunocompetent patients (soft palate, lingual frenum)
  • Pink to whitish pink, exophytic papillary growths with pedunculated outline
  • May be solitary or multiple and variably sized, up to 2 to 3 cm
  • Can present as papillomatosis of upper respiratory tract
• Focal epithelial hyperplasia (Heck's disease)

  A viral infection (HPV 13 or 32), usually found in childhood, often occurs in native Americans
• Focal epithelial hyperplasia


  • Numerous, slightly raised whitish pink asymptomatic papules and irregular plaques that may become confluent
  • Size of lesions ranges from a few millimeters to coalescent papules several centimeters in dimension
• Keratoacanthoma


  A skin lesion that erupts in sun-damaged skin, grows for a few months then may shrink and resolve, considered a variant of squamous cell carcinoma
• Keratoacanthoma


  • Usually solitary on sun-exposed areas, including lip
  • Initially erythematous papule
  • Rapid growth over 4 to 8 weeks
  • Nodular, hemispheric, firm nodule
  • Central keratin core
  • Occasionally regresses spontaneously
  • Extremely rare intraorally