Frictional and Focal Hyperkeratosis Quiz

Frictional Hyperkeratosis

• A white lesion with a roughened keratotic surface caused by chronic mechanical irritation.
• It is reversible after eliminating the trauma.
• It should not be mistaken for true leukoplakia.
• It is a result of the body's protective response to friction.
• Non-keratinized epithelium responds with acanthosis and keratinization.
• Keratinized epithelium responds with additional keratin formation.

Focal Hyperkeratosis

• A specific type of hyperkeratosis localized to a specific area.
• Can be caused by tongue-thrusting habits.
• Can be caused by cheek biting.
• May be caused by chronic rubbing of the lip against teeth which is categorized as Linea Alba

Chemical Trauma

• Can be caused by topical application of acetylsalicylic acid (Aspirin Burn).
• Can be caused by the use of spit tobacco (Snuff Dipper's Pouch Hyperkeratosis).

Neoplasm

• A new mass of tissue with abnormal and uncontrolled growth.
• Neoplasms are classified as either benign or malignant.
• Neoplasms can be central (involving the root of the tooth) or peripheral (involving the soft tissues around the tooth).

Site

• Neoplasms can be classified based on the tissue they involve.
• Cysts are filled with fluids.
• Soft tissue Neoplasms contain soft tissue.
• Calcified tissue Neoplasms contain bone or cementum.
• Mixed Neoplasms involve multiple types of tissue.

Symptoms

• Pain can be sharp, indicating acute inflammation, or dull, indicating chronic inflammation.
• Paresthesia is an abnormal sensation, such as tingling or burning.
• Numbness indicates a loss of sensation.
• Tenderness indicates pain on digital pressure.

Neoplasia vs. Hyperplasia

• Neoplasia has a spontaneous etiology, while hyperplasia has identifiable causes such as trauma or low-grade irritation.
• Neoplasia is capable of unlimited proliferation, which hyperplasia is not.
• Neoplasia does not regress after removing the cause, while hyperplasia can regress.

Duration

• Acute inflammation has a short duration of days, while malignant neoplasms take months.
• Benign neoplasms or reactive conditions can take years.

Character of Growth

• Slow growth is characteristic of benign neoplasms or reactive conditions, while fast growth indicates malignant neoplasms.

Signs

• Shape, surface texture, base, color, borders, and number are all characteristics that help define neoplasms.

Shape

• Flat surface lesions include macules, patches, and plaques.
• Depressed surface lesions include ulcers and erosions.
• Elevated surface lesions include papules, papillomatous growths, verruca, nodules, and submucosal masses.

Surface Texture

• Surface texture can be smooth or rough, depending on the type of neoplasm.

Base

• Neoplasms can be sessile (attached by a broad base) or pedunculated (attached by a narrow stalk).

Color

• White lesions can be caused by hyperkeratosis, acanthosis, spongiosis, or fibrosis.
• Red lesions are caused by increased vascularity, thin overlying epithelium, or hemorrhage.
• Brown lesions are caused by melanin pigments.

Borders and Number

• Well-defined borders are typically associated with benign tumors, while irregular borders are associated with malignant neoplasms.
• Solitary lesions can be benign or malignant, while multiple lesions are more likely to be malignant.

Histopathology

• The microscopic examination of tissues can help identify the type of neoplasm.

Normal Oral Mucosa

• The oral mucosa can be keratinized (gingiva and hard palate) or non-keratinized (lining of the cheek and floor of the mouth).
• Keratinized mucosa has four layers: basal cell layer, spinous cell layer, granular cell layer, and surface keratin layer.
• Non-keratinized mucosa has: stratum basal, stratum intermedia, and stratum superficial.

Basal Cell Layer

• The basal cell layer contains stem cells that can differentiate into different cell types, including squamous cells and keratin.

Spinous Cell Layer

• The spinous cell layer contains polyhydral cells that are adherent to each other by desmosomal junctions.
• The cells mature toward the surface as they move away from the basal cell layer.

Acanthosis & Hyperkeratinization

• Acanthosis is an increase in the number of cells in the spinous cell layer.
• Hyperkeratosis is an excessive thickening of the keratin layer, which can be categorized as orthokeratin or parakeratin.

Epithelial Hyperplasia

• Acanthosis and hyperkeratinization are both examples of epithelial hyperplasia.
• Hyperplasia is an increase in the number of cells in a tissue.

Test your knowledge on frictional and focal hyperkeratosis, their causes, and distinctions. Understand the impacts of chemical trauma and neoplasms related to these conditions. This quiz will assess your grasp of these dermatological topics and their clinical implications.