Epstein’s Pearls

Synonyms

Palatal cyst of the newborn

Definition

Small, developmental inclusion cysts in the newborn infants along the median palatal raphe believed to arise from epithelium entrapped along the line of fusion. Identical cysts scattered on the hard palate near the soft palate junction or on the buccal and lingual aspect of the alveolar ridge are called Bohn’s nodules and on the gingiva, gingival, or alveolar cysts/dental lamina cysts of the newborn, originating from the dental lamina.

Clinical Features

Incidence

65–85% of all newborns.

Age

Neonates, rarely after 3 months.

Sex

No gender predilection.

Site

Small, 1–3 mm, white or yellow–white papules along the median raphe of the hard palate. Single or multiple.

Treatment

Self-healing within a few weeks. The small cysts rupture spontaneously or degenerate.

Microscopy

Keratin-filled cysts, lined by stratified squamous epithelium, sometimes communicating with the surface (Fig. 1).

Fig. 1

Subepithelial located squamous epithelium lined cyst...