Natarajan Easwar, Woo Sook-Bin
Department of Oral Health and Diagnostic Sciences, University of Connecticut School of Dental Medicine, Farmington, Connecticut 06030, USA.
J Am Acad Dermatol. 2008 Jan;58(1):151-7. doi: 10.1016/j.jaad.2007.07.011.
Benign alveolar ridge keratosis is a common benign white papule or plaque that occurs on the keratinized gingiva of the maxillary or mandibular alveolar ridge that is probably traumatic/frictional in origin, with characteristic histologic features, similar to those of lichen simplex chronicus of the skin. This is a retrospective study of 108 consecutive specimens displaying characteristic histopathologic features of benign alveolar ridge keratosis accessioned during a 36-month period. There was a male:female ratio of 3.7:1. It occurred on the attached gingiva, with the retromolar area and the edentulous alveolar ridge involved in 51% and 49% of cases, respectively; 19% were bilateral and all bilateral cases were on the retromolar pad. Detailed clinical information was available on 27 cases by a mail-in questionnaire. Histologically, the lesions were characterized by moderate to marked hyperorthokeratosis and wedge-shaped hypergranulosis. The epithelium exhibited slight surface papillomatosis and acanthosis in the form of long, tapered rete ridges that frequently anastomosed at the base. There was generally insignificant inflammation. These features are similar if not identical to lichen simplex chronicus of the skin, a benign condition caused by chronic irritation. Ten randomly selected cases were immunostained for p16INK4A(p16), a tumor suppressor protein expressed in dysplastic epithelium. All lesions were negative for p16. Benign alveolar ridge keratosis is a specific clinicopathologic entity that should be removed from the category of leukoplakia as is currently the practice for clinical white lesions with a specific, consistently recognizable histologic appearance.
良性牙槽嵴角化病是一种常见的良性白色丘疹或斑块，发生在上颌或下颌牙槽嵴的角化牙龈上，其病因可能是创伤性/摩擦性的，具有特征性的组织学特征，与皮肤慢性单纯性苔藓相似。这是一项回顾性研究，对在36个月期间入组的108例连续标本进行分析，这些标本显示出良性牙槽嵴角化病的特征性组织病理学特征。男女比例为3.7:1。它发生在附着龈，磨牙后区和无牙牙槽嵴分别累及51%和49%的病例；19%为双侧病变，所有双侧病例均位于磨牙后垫。通过邮寄问卷可获得27例病例的详细临床信息。组织学上，病变的特征为中度至重度正角化过度和楔形颗粒层增厚。上皮表现为轻度表面乳头瘤样增生和棘层肥厚，呈长而逐渐变细的 rete 嵴形式，在基部常相互吻合。通常炎症不明显。这些特征即使不完全相同，也与皮肤慢性单纯性苔藓相似，后者是一种由慢性刺激引起的良性疾病。随机选择10例病例进行p16INK4A（p16）免疫染色，p16是一种在发育异常上皮中表达的肿瘤抑制蛋白。所有病变p16均为阴性。良性牙槽嵴角化病是一种特定的临床病理实体，应从白斑类别中剔除，目前对于具有特定、一致可识别组织学表现的临床白色病变就是这样处理的。
