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Benign Alveolar Ridge Keratosis: Clinical and Histopathologic Analysis of 167 Cases

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Abstract

Benign alveolar ridge keratosis (BARK), the intraoral counterpart of cutaneous lichen simplex chronicus, is a reactive hyperkeratosis caused by trauma or friction that presents as a poorly demarcated white papule or plaque on the keratinized mucosa of the retromolar pad or alveolar ridge mucosa (often edentulous). This is a clinical and histopathologic analysis of BARK including evaluation of p53 expression in selected cases. One hundred and sixty-seven cases of BARK were identified from 2016 to 2017 and 112 (67.1%) occurred in males with a median age of 56 years (range 15–86). The retromolar pad was affected in 107 (64.1%) cases and the edentulous alveolar mucosa in 60 (35.9%) cases, with 17.4% of the cases presenting bilaterally. BARK showed hyperkeratosis often with wedge-shaped hypergranulosis and occasional focal parakeratosis. The epithelium exhibited acanthosis and surface corrugation with tapered rete ridges often interconnected at the tips. The study for p53 performed in 12 cases showed less than 25% nuclear positivity. BARK is a distinct benign clinicopathologic entity caused by friction, which should be clearly distinguished from true leukoplakia, a potentially malignant disorder.

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Authors and Affiliations

  1. Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, 02215, USA

    Asma Almazyad, Chia-Cheng Li & Sook-Bin Woo

  2. Maxillofacial Surgery and Diagnostic Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia

    Asma Almazyad

  3. Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA

    Chia-Cheng Li

  4. Center for Oral Pathology, StrataDx, Lexington, MA, USA

    Sook-Bin Woo

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  1. Asma Almazyad
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  2. Chia-Cheng Li
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Correspondence to Asma Almazyad.

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Almazyad, A., Li, CC. & Woo, SB. Benign Alveolar Ridge Keratosis: Clinical and Histopathologic Analysis of 167 Cases. Head and Neck Pathol 14, 915–922 (2020). https://doi.org/10.1007/s12105-020-01151-1

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  • DOI: https://doi.org/10.1007/s12105-020-01151-1

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