Abstract
White sponge nevus (WSN) is a rare autosomal dominant disorder that results in soft, white, and spongy plaques in the oral cavity. The buccal mucosa is the most commonly affected site, followed by lips, alveolar ridges and floor of the mouth. The histopathologic features of WSN include epithelial thickening, hyperkeratosis and vacuolization of the keratinocytes in the suprabasal layers. Because of lack of clinical complaint, no treatment has been proposed, thus clinical follow-up is used as the chosen means of management. Here is a case report of white sponge nevus in a 25 year old male patient affecting the right buccal mucosa.
Key words: Dyskeratosis, white lesion, white sponge nevus
Introduction …show more content…
It was smaller in size but has gradually attained its present size during the span of 5-6 years. There is no relevant past dental history or medical history. In the family history, patient’s brother also had similar type of patch in relation to his left buccal mucosa since 25 years (Figure 2). On general physical examination all the vital signs were in normal range. No abnormality was detected on systemic evaluation and extra-oral examination. On intra-oral examination a white plaque with well defined margins, which is translucent measuring approximately 2.5 x 2.0 cm was present in relation to right buccal mucosa extending anteroposteriorly 0.5 cm away from retro commissural area to middle of buccal mucosa and supero-inferiorly above and below occlusal line. On palpation it was smooth and shiny, soft, non-tender and non–scrappable. Based on history and clinical examination a provisional diagnosis of White sponge nevus was given with a differential diagnosis homogenous leukoplakia, pseudomembranous candidiasis and dyskeratosis congenita. On haematological investigations all the values were within normal limits and a punch biopsy was performed as an investigative procedure. The histopathological report revealed hyperplastic epithelium with hyperparakeratinization and acanthosis, broad, and elongated rete …show more content…
Hercílio Martelli, Jr, Samantha Mourão Pereirab, Thábata Martins Rochab, Paulo Luis Antônio Nogueira dos Santos, Alfredo Maurício Batista de Paula, and Paulo Rogério Ferreti Bonan. White sponge nevus: report of a three-generation family. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103:43-7
3. Martin S. Greenberg, Michael Glick, Jonathan A. Ship. Burkit’s Oral Medicine Eleventh Edition: 77-106
4. Frithiof L, Banoczy J. White sponge nevus (leukoedema exfoliativum mucosae oris): ultrastructural observations. Oral Surg 1976; 41: 607–622.
5. Van Muijen GN, Ruiter DJ, Franke WW et al (1986). Cell type heterogeneity of cytokeratin expression in complex epithelia and carcinomas as demonstrated by monoclonal antibodies specific for cytokeratins nos. 4 and 13. Exp Cell Res 162: 97–113.
6. Yasuyuki Shibuya, Jianming Zhang, Satoshi Yokoo, Masahiro Umeda, and Takahide Komori. Constitutional mutation of keratin 13 gene in familial white sponge nevus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;96:561-5
7. EL Rugg, GJ Magee, NJ Wilson, F Brandrup, J Hamburger, EB Lane. Identification of two novel mutations in keratin 13 as the cause of white sponge nevus. Oral Diseases 1999; 5: 321–324
8. Shafer’s textbook of oral pathology, 5th edition: