The patient was a 21-year-old Iranian male referred to the Department of Oral Medicine at Tabriz University of Medical Sciences Faculty of Dentistry for diagnosis and management of a “white, itchy spot” on the buccal mucosa. White bilateral lesion in oral mucosa was the chief compliant of the patient. The patient complained of a white lesion which was present since birth.
The patient’s general health was reportedly good. The patient denied presence of a similar condition in immediate family members or any similar lesions elsewhere on his body.
In clinical examination, there were bilateral, symmetrical white plaques and patches on the buccal and labial mucosa, which could not be removed
(). The plaques were smooth with velvety texture and irregular, well-defined borders. There was no elevation or erythema. The margins were clear and no lymph nodes were noticeable. Oral hygiene was good and other oral structures were normal in appearance.
Figure 1. Clinical views of the lesions.
In histopathologic evaluation, oral mucosa covered by stratified squamous epithelium revealed prominent hyperparakeratosis and marked acanthosis with clearing of the cytoplasm of cells in the spinous layer. In addition, eosinophilic condensation was noted in the perinuclear region of the cells in superficial layers
(). Underlying connective tissue was normal in appearance with rare chronic inflammatory cell infiltration.
Figure 2. (a) Histopathologic view of the lesion (×10); (b) perinuclear condensation of keratin tonofilament (arrow) (×40) (H&E).
Based on clinical data and histopathologic findings, the lesion was consistent with white sponge nevus. Because of benign nature of this lesion, no treatment is necessary and only biopsy and correct diagnosis is necessary to rule out other similar lesions. Six-month follow-up was recommended.