Forum for Clinical and Surgical Oral Pathology

Case BBOPF 14-4

Dr. Joseph Rinaggio (Rutgers School of Dental Medicine, Newwark, New Jersey. USA) is requesting your opinion. Please send your comments in the window located below the images. This case will be posted from December 12 – December 19, 2014. A summary of the responses will be posted in BBOP.

This is 72-year-old male who has recurrent bouts of the lesions illustrated in Fig. 1. They are transient, and there is no apparent temporal association to anything, no known allergies, and no significant medical history as far as I am aware. They are painless. The biopsy is non-specific; epithelial hyperplasia and thick hyperparakeratinization. PAS negative. There is some basilar reactive atypia, but nothing alarming. The odd thing is that in the parakeratin, there are vertically oriented capillaries without any adjacent connective tissue,just vertical capillaries in the parakeratin. I’ve never seen anything like it, and I can’t find any mention of such a thing in any textbook. A MEDLINE search has been fruitless. Has anyone ever encountered anything like this?

Joseph Rinaggio, DDS, MS
Associate Professor
Departments of Diagnostic Sciences and Endodontics
Rutgers School of Dental Medicine
Newark, New Jersey

Images

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[Click for a larger image] Figure 1	[Click for a larger image] Figure 2	[Click for a larger image] Figure 3
[Click for a larger image] Figure 4	[Click for a larger image] Figure 5

Case prepared by Dr. Alfredo Aguirre (BBOP Manager) and Daniel Emmer (Web Administrator, University at Buffalo School of Dental Medicine).