Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, 02215, USA.
Maxillofacial Surgery and Diagnostic Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia.
Head Neck Pathol. 2020 Dec;14(4):915-922. doi: 10.1007/s12105-020-01151-1. Epub 2020 Mar 16.
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.
良性牙槽嵴角化病（BARK），是口腔内类似于皮肤慢性单纯性苔藓的病变，是一种由创伤或摩擦引起的反应性过度角化，表现为磨牙后垫或牙槽嵴黏膜角化区的无明显界限的白色丘疹或斑块（常为无牙区）。本文通过对 BARK 进行临床和组织病理学分析，包括对部分病例中 p53 表达的评估。我们在 2016 年至 2017 年期间共发现了 167 例 BARK 病例，其中 112 例（67.1%）为男性，中位年龄为 56 岁（范围 15-86 岁）。107 例（64.1%）发生于磨牙后垫，60 例（35.9%）发生于无牙牙槽嵴黏膜，17.4%的病例为双侧发病。BARK 表现为过度角化，常伴有楔形过度角化和偶发的局灶性不全角化。上皮表现为棘层肥厚和表面皱襞，其乳头呈锥形，常相互交织。在 12 例进行 p53 研究的病例中，核阳性率低于 25%。BARK 是一种由摩擦引起的明确的良性临床病理实体，应与潜在恶性病变真性白斑相区别。
