White and Red Lesions of the Oral Mucosa

  • Maryam Jessri
  • Hani Mawardi
  • Camile S. FarahEmail author
  • Sook-Bin Woo
Reference work entry


There are several conditions that can present as white or red macular, papular, and/or plaque-like lesions of the oral mucosa. Based on etiology, red and white lesions of the oral cavity can be divided into developmental, reactive, infectious, immune-mediated/autoimmune, and potentially malignant and malignant conditions. Whiteness of the oral mucosa can be caused by changes in the epithelium such as keratinization of normally nonkeratinized mucosa (such as the buccal mucosa), increased keratinization of normally keratinized mucosa, abnormal keratinization of the epithelium, thickening of the epithelium, and epithelial edema. Fibrosis and/or reduced vascularity of the underlying mucosa may also lead to whiteness which tends to appear deep without discernible surface alterations. Some of the more common causes of redness (erythema) of the oral mucosa include reduced keratinization of the oral epithelium, epithelial atrophy, erosion or inflammation, and vascular dilatation or proliferation. Generally, the prevalence of red and white oral lesions increases with age. Based on diagnostic and inclusion criteria, and characteristics of the population, prevalence of oral mucosal lesions has been reported in 2–84% of the population (Do et al. 2014). A large proportion of red and white lesions are benign. However, the most common premalignant condition in the oral cavity is a white plaque (leukoplakia), and this must be managed expeditiously and appropriately. Many conditions can be accurately diagnosed with careful history taking and clinical examination. However, a biopsy is often necessary for a definitive diagnosis. This chapter discusses the clinical features of these white and red lesions, how to distinguish between them, and how to manage them.


White lesions Red lesions Premalignant lesions Mucosal pathology Benign mucosal pathology Developmental conditions Reactive conditions Potentially malignant lesions Malignant lesions Oral squamous cell carcinoma 


  1. Abadie WM, Partington EJ, Fowler CB, Schmalbach CE. Optimal management of proliferative verrucous leukoplakia: a systematic review of the literature. Otolaryngol Head Neck Surg. 2015;153(4):504–11.CrossRefGoogle Scholar
  2. Agrawal N, Frederick MJ, Pickering CR, Bettegowda C, Chang K, Li RJ, Fakhry C, Xie TX, Zhang J, Wang J, Zhang N, El-Naggar AK, Jasser SA, Weinstein JN, Treviño L, Drummond JA, Muzny DM, Wu Y, Wood LD, Hruban RH, Westra WH, Koch WM, Califano JA, Gibbs RA, Sidransky D, Vogelstein B, Velculescu VE, Papadopoulos N, Wheeler DA, Kinzler KW, Myers JN. Exome sequencing of head and neck squamous cell carcinoma reveals inactivating mutations in NOTCH1. Science. 2011;333(6046):1154–7.PubMedCentralCrossRefPubMedGoogle Scholar
  3. Allingham RR, Seo B, Rampersaud E, Bembe M, Challa P, Liu N, Parrish T, Karolak L, Gilbert J, Pericak-Vance MA, Klintworth GK, Vance JM. A duplication in chromosome 4q35 is associated with hereditary benign intraepithelial dyskeratosis. Am J Hum Genet. 2001;68(2):491–4.PubMedCentralCrossRefPubMedGoogle Scholar
  4. Altman J, Perry HO. The variations and course of lichen planus. Arch Dermatol. 1961;84:179–91.CrossRefGoogle Scholar
  5. Alvarez Gomez GJ, Alvarez Martinez E, Jimenez Gomez R, Mosquera Silva Y, Gaviria Nunez AM, Garces Agudelo A, Alonso Duque A, Zabala Castano A, Echeverri Gonzalez E, Isaac Millan M, Ramirez Ossa D. Reverse smokers’s and changes in oral mucosa. Department of Sucre, Colombia. Med Oral Patol Oral Cir Bucal. 2008;13(1):E1–8.Google Scholar
  6. Anderson A, Ishak N. Marked variation in malignant transformation rates of oral leukoplakia. Evid Based Dent. 2015;16(4):102–3.CrossRefGoogle Scholar
  7. Angadi PV, Rao SS. Areca nut in pathogenesis of oral submucous fibrosis: revisited. Oral Maxillofac Surg. 2011;15(1):1–9.CrossRefGoogle Scholar
  8. Anil S. Plasma cell gingivitis among herbal toothpaste users: a report of three cases. J Contemp Dent Pract. 2007;8(4):60–6.Google Scholar
  9. Arakeri G, Brennan PA. Oral submucous fibrosis: an overview of the aetiology, pathogenesis, classification, and principles of management. Br J Oral Maxillofac Surg. 2013;51(7):587–93.CrossRefGoogle Scholar
  10. Assimakopoulos D, Patrikakos G, Fotika C, Elisaf M. Benign migratory glossitis or geographic tongue: an enigmatic oral lesion. Am J Med. 2002;113(9):751–5.CrossRefGoogle Scholar
  11. Auquier-Dunant A, Mockenhaupt M, Naldi L, Correia O, Schroder W, Roujeau JC. Correlations between clinical patterns and causes of erythema multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis: results of an international prospective study. Arch Dermatol. 2002;138(8):1019–24.CrossRefGoogle Scholar
  12. Axell T, Holmstrup P, Kramer RH, Pindborg JJ, Shear M. International seminar on oral leukoplakia and associated lesions related to tobacco habits. Community Dent Oral Epidemiol. 1984;12(3):145–54.CrossRefGoogle Scholar
  13. Bagan J, Scully C, Jimenez Y, Martorell M. Proliferative verrucous leukoplakia: a concise update. Oral Dis. 2010;16(4):328–32.CrossRefGoogle Scholar
  14. Bagan JV, Jimenez-Soriano Y, Diaz-Fernandez JM, Murillo-Cortes J, Sanchis-Bielsa JM, Poveda-Roda R, Bagan L. Malignant transformation of proliferative verrucous leukoplakia to oral squamous cell carcinoma: a series of 55 cases. Oral Oncol. 2011;47(8):732–5.CrossRefGoogle Scholar
  15. Banoczy J, Szabo L, Csiba A. Migratory glossitis. A clinical-histologic review of seventy cases. Oral Surg Oral Med Oral Pathol. 1975;39(1):113–21.CrossRefGoogle Scholar
  16. Bastuji-Garin S, Rzany B, Stern RS, Shear NH, Naldi L, Roujeau JC. Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme. Arch Dermatol. 1993;129(1):92–6.CrossRefGoogle Scholar
  17. Bhatia N, Lalla Y, Vu AN, Farah CS. Advances in optical adjunctive AIDS for visualisation and detection of oral malignant and potentially malignant lesions. Int J Dent. 2013;2013:194029.PubMedCentralCrossRefPubMedGoogle Scholar
  18. Bhatia N, Matias MA, Farah CS. Assessment of a decision making protocol to improve the efficacy of VELscope in general dental practice: a prospective evaluation. Oral Oncol. 2014;50(10):1012–9.CrossRefGoogle Scholar
  19. Bhayat A, Yengopal V, Rudolph M. Predictive value of group I oral lesions for HIV infection. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(5):720–3.CrossRefGoogle Scholar
  20. Brouns E, Baart J, Karagozoglu K, Aartman I, Bloemena E, van der Waal I. Malignant transformation of oral leukoplakia in a well-defined cohort of 144 patients. Oral Dis. 2014;20(3):e19–24.CrossRefGoogle Scholar
  21. Cabay RJ, Morton Jr TH, Epstein JB. Proliferative verrucous leukoplakia and its progression to oral carcinoma: a review of the literature. J Oral Pathol Med. 2007;36(5):255–61.CrossRefGoogle Scholar
  22. Camara PR, Dutra SN, Takahama Junior A, Fontes KB, Azevedo RS. A comparative study using WHO and binary oral epithelial dysplasia grading systems in actinic cheilitis. Oral Dis. 2016 Sep;22(6):523–9.CrossRefGoogle Scholar
  23. CancerGenomeAtlasNetwork. Comprehensive genomic characterization of head and neck squamous cell carcinomas. Nature. 2015;517(7536):576–82.CrossRefGoogle Scholar
  24. Carrozzo M, Brancatello F, Dametto E, Arduino P, Pentenero M, Rendine S, Porter SR, Lodi G, Scully C, Gandolfo S. Hepatitis C virus-associated oral lichen planus: is the geographical heterogeneity related to HLA-DR6? J Oral Pathol Med. 2005;34(4):204–8.CrossRefGoogle Scholar
  25. Cerero-Lapiedra R, Balade-Martinez D, Moreno-Lopez LA, Esparza-Gomez G, Bagan JV. Proliferative verrucous leukoplakia: a proposal for diagnostic criteria. Med Oral Patol Oral Cir Bucal. 2010;15(6):e839–45.CrossRefGoogle Scholar
  26. Cheng YL, Gould A, Kurago Z, Fantasia J, Muller S. Diagnosis of oral lichen planus: a position paper of the American Academy of oral and maxillofacial pathology. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;122:332–54.CrossRefGoogle Scholar
  27. Chi AC, Lambert 3rd PR, Pan Y, Li R, Vo DT, Edwards E, Gangarosa P, Neville BW. Is alveolar ridge keratosis a true leukoplakia?: a clinicopathologic comparison of 2,153 lesions. J Am Dent Assoc. 2007;138(5):641–51.CrossRefGoogle Scholar
  28. Choudhry R, Hodgins MB, Van der Kwast TH, Brinkmann AO, Boersma WJ. Localization of androgen receptors in human skin by immunohistochemistry: implications for the hormonal regulation of hair growth, sebaceous glands and sweat glands. J Endocrinol. 1992;133(3):467–75.CrossRefGoogle Scholar
  29. Cummings TJ, Dodd LG, Eedes CR, Klintworth GK. Hereditary benign intraepithelial dyskeratosis: an evaluation of diagnostic cytology. Arch Pathol Lab Med. 2008;132(8):1325–8.Google Scholar
  30. Dai W, Li Y, Zhou Q, Xu Z, Sun C, Tan X, Lu L. Cetuximab inhibits oral squamous cell carcinoma invasion and metastasis via degradation of epidermal growth factor receptor. J Oral Pathol Med. 2014;43(4):250–7.CrossRefGoogle Scholar
  31. De Rossi SS, Ciarrocca K. Oral lichen planus and lichenoid mucositis. Dent Clin N Am. 2014;58(2):299–313.PubMedCentralCrossRefPubMedGoogle Scholar
  32. Demarosi F, Lodi G, Carrassi A, Soligo D, Sardella A. Oral malignancies following HSCT: graft versus host disease and other risk factors. Oral Oncol. 2005;41(9):865–77.CrossRefGoogle Scholar
  33. Do LG, Spencer AJ, Dost F, Farah CS. Oral mucosal lesions: findings from the Australian national survey of adult oral health. Aust Dent J. 2014;59(1):114–20.CrossRefGoogle Scholar
  34. Dongo M, Goncalves LS, Ferreira SM, Noce CW, Dias EP, Junior AS. Gender differences in oral manifestations among HIV-infected Brazilian adults. Int Dent J. 2013;63(4):189–95.CrossRefGoogle Scholar
  35. Dost F, Le Cao K, Ford PJ, Ades C, Farah CS. Malignant transformation of oral epithelial dysplasia: a real-world evaluation of histopathologic grading. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;117(3):343–52.CrossRefGoogle Scholar
  36. Farthing P, Bagan JV, Scully C. Mucosal disease series. Number IV. Erythema multiforme. Oral Dis. 2005;11(5):261–7.CrossRefGoogle Scholar
  37. Ferrara JL, Levine JE, Reddy P, Holler E. Graft-versus-host disease. Lancet. 2009;373(9674):1550–61.PubMedCentralCrossRefPubMedGoogle Scholar
  38. Francalanci S, Sertoli A, Giorgini S, Pigatto P, Santucci B, Valsecchi R. Multicentre study of allergic contact cheilitis from toothpastes. Contact Dermatitis. 2000;43(4):216–22.CrossRefGoogle Scholar
  39. Garcia-Pola MJ, Llorente-Pendas S, Seoane-Romero JM, Berasaluce MJ, Garcia-Martin JM. Thyroid disease and oral lichen Planus as comorbidity: a prospective case-control study. Dermatology. 2016;232(2):214–9.CrossRefGoogle Scholar
  40. Goldman GD. Treatment of actinic cheilitis. Dermatol Surg. 2015;41(10):1193–4.CrossRefGoogle Scholar
  41. Gomes CC, Fonseca-Silva T, Galvao CF, Friedman E, De Marco L, Gomez RS. Inter- and intra-lesional molecular heterogeneity of oral leukoplakia. Oral Oncol. 2015;51(2):178–81.CrossRefGoogle Scholar
  42. Goregen M, Melikoglu M, Miloglu O, Erdem T. Predisposition of allergy in patients with benign migratory glossitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110(4):470–4.CrossRefGoogle Scholar
  43. Greenspan JS, Greenspan D, Webster-Cyriaque J. Hairy leukoplakia; lessons learned: 30-plus years. Oral Dis. 2016;22(Suppl 1):120–7.CrossRefGoogle Scholar
  44. Gurvits GE, Tan A. Black hairy tongue syndrome. World J Gastroenterol. 2014;20(31):10845–50.PubMedCentralCrossRefPubMedGoogle Scholar
  45. Haddad R, Annino D, Tishler RB. Multidisciplinary approach to cancer treatment: focus on head and neck cancer. Dent Clin N Am. 2008;52(1):1–17, vii.CrossRefGoogle Scholar
  46. Heyl T, Raubenheimer EJ. Sucking pads (sucking calluses) of the lips in neonates: a manifestation of transient leukoedema. Pediatr Dermatol. 1987;4(2):123–8.CrossRefGoogle Scholar
  47. Hsue SS, Wang WC, Chen CH, Lin CC, Chen YK, Lin LM. Malignant transformation in 1458 patients with potentially malignant oral mucosal disorders: a follow-up study based in a Taiwanese hospital. J Oral Pathol Med. 2007;36(1):25–9.CrossRefGoogle Scholar
  48. Ion D, Stevenson K, Woo SB, Ho VT, Soiffer R, Antin JH, Treister NS. Characterization of oral involvement in acute graft-versus-host disease. Biol Blood Marrow Transplant. 2014;20(11):1717–21.PubMedCentralCrossRefPubMedGoogle Scholar
  49. Ippolito A, Wallace DJ, Gladman D, Fortin PR, Urowitz M, Werth V, Costner M, Gordon C, Alarcon GS, Ramsey-Goldman R, Maddison P, Clarke A, Bernatsky S, Manzi S, Bae SC, Merrill JT, Ginzler E, Hanly JG, Nived O, Sturfelt G, Sanchez-Guerrero J, Bruce I, Aranow C, Isenberg D, Zoma A, Magder LS, Buyon J, Kalunian K, Dooley MA, Steinsson K, van Vollenhoven RF, Stoll T, Weisman M, Petri M. Autoantibodies in systemic lupus erythematosus: comparison of historical and current assessment of seropositivity. Lupus. 2011;20(3):250–5.CrossRefGoogle Scholar
  50. Isaac-Renton M, Li MK, Parsons LM. Cinnamon spice and everything not nice: many features of intraoral allergy to cinnamic aldehyde. Dermatitis. 2015;26(3):116–21.CrossRefGoogle Scholar
  51. Izutsu T, Kumamoto H, Kimizuka S, Ooya K. Sebaceous adenoma in the retromolar region: report of a case with a review of the English literature. Int J Oral Maxillofac Surg. 2003;32(4):423–6.CrossRefGoogle Scholar
  52. Jacob BJ, Straif K, Thomas G, Ramadas K, Mathew B, Zhang ZF, Sankaranarayanan R, Hashibe M. Betel quid without tobacco as a risk factor for oral precancers. Oral Oncol. 2004;40(7):697–704.CrossRefGoogle Scholar
  53. Jainkittivong A, Langlais RP. Geographic tongue: clinical characteristics of 188 cases. J Contemp Dent Pract. 2005;6(1):123–35.Google Scholar
  54. Jessri M, Farah CS. Harnessing massively parallel sequencing in personalized head and neck oncology. J Dent Res. 2014;93(5):437–44.CrossRefGoogle Scholar
  55. Jordan RC, Macabeo-Ong M, Shiboski CH, Dekker N, Ginzinger DG, Wong DT, Schmidt BL. Overexpression of matrix metalloproteinase-1 and -9 mRNA is associated with progression of oral dysplasia to cancer. Clin Cancer Res. 2004;10(19):6460–5.CrossRefGoogle Scholar
  56. Kamath KP, Mishra S, Anand PS. Smokeless tobacco use as a risk factor for periodontal disease. Front Public Health. 2014;2:195.PubMedCentralCrossRefPubMedGoogle Scholar
  57. Kataoka Y, Iwasaki T, Kuroiwa T, Seto Y, Iwata N, Hashimoto N, Ogata A, Hamano T, Kakishita E. The role of donor T cells for target organ injuries in acute and chronic graft-versus-host disease. Immunology. 2001;103(3):310–8.PubMedCentralCrossRefPubMedGoogle Scholar
  58. Kerr DA, McClatchey KD, Regezi JA. Idiopathic gingivostomatitis. Cheilitis, glossitis, gingivitis syndrome; atypical gingivostomatitis, plasma-cell gingivitis, plasmacytosis of gingiva. Oral Surg Oral Med Oral Pathol. 1971;32(3):402–23.CrossRefGoogle Scholar
  59. Kuo TM, Luo SY, Chiang SL, Yeh KT, Hsu HT, Wu CT, Lu CY, Tsai MH, Chang JG, Ko YC. Fibrotic effects of arecoline N-oxide in oral potentially malignant disorders. J Agric Food Chem. 2015;63(24):5787–94.CrossRefGoogle Scholar
  60. Kuribayashi Y, Tsushima F, Sato M, Morita K, Omura K. Recurrence patterns of oral leukoplakia after curative surgical resection: important factors that predict the risk of recurrence and malignancy. J Oral Pathol Med. 2012;41(9):682–8.CrossRefGoogle Scholar
  61. Laimer K, Spizzo G, Gastl G, Obrist P, Brunhuber T, Fong D, Barbieri V, Jank S, Doppler W, Rasse M, Norer B. High EGFR expression predicts poor prognosis in patients with squamous cell carcinoma of the oral cavity and oropharynx: a TMA-based immunohistochemical analysis. Oral Oncol. 2007;43(2):193–8.CrossRefGoogle Scholar
  62. Langley A, Anooshiravani N, Kwan S, Zeller J, Pope E. Erythema multiforme in children and Mycoplasma pneumoniae aetiology. J Cutan Med Surg. 2016;20(5):453–7.CrossRefGoogle Scholar
  63. Lavanya N, Jayanthi P, Rao UK, Ranganathan K. Oral lichen planus: an update on pathogenesis and treatment. J Oral Maxillofac Pathol. 2011;15(2):127–32.PubMedCentralCrossRefPubMedGoogle Scholar
  64. Lee JJ, Hung HC, Cheng SJ, Chiang CP, Liu BY, Yu CH, Jeng JH, Chang HH, Kok SH. Factors associated with underdiagnosis from incisional biopsy of oral leukoplakic lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007a;104(2):217–25.CrossRefGoogle Scholar
  65. Lee SJ, Klein J, Haagenson M, Baxter-Lowe LA, Confer DL, Eapen M, Fernandez-Vina M, Flomenberg N, Horowitz M, Hurley CK, Noreen H, Oudshoorn M, Petersdorf E, Setterholm M, Spellman S, Weisdorf D, Williams TM, Anasetti C. High-resolution donor-recipient HLA matching contributes to the success of unrelated donor marrow transplantation. Blood. 2007b;110(13):4576–83.CrossRefGoogle Scholar
  66. Lee WJ, Huang EY, Tsai CM, Kuo KC, Huang YC, Hsieh KS, Niu CK, Yu HR. The role of serum Mycoplasma pneumoniae IgA, IgM, and IgG for the diagnosis of Mycoplasma pneumonia-related pneumonia in school-age children and adolescents. Clin Vaccine Immunol. 2017 Jan 5;24(1). pii: e00471-16.Google Scholar
  67. Lingen MW, Pinto A, Mendes RA, Franchini R, Czerninski R, Tilakaratne WM, Partridge M, Peterson DE, Woo SB. Genetics/epigenetics of oral premalignancy: current status and future research. Oral Dis. 2011;17(Suppl 1):7–22.CrossRefGoogle Scholar
  68. Liu W, Shi LJ, Wu L, Feng JQ, Yang X, Li J, Zhou ZT, Zhang CP. Oral cancer development in patients with leukoplakia – clinicopathological factors affecting outcome. PLoS One. 2012;7(4):e34773.PubMedCentralCrossRefPubMedGoogle Scholar
  69. Lo Russo L, Fedele S, Guiglia R, Ciavarella D, Lo Muzio L, Gallo P, Di Liberto C, Campisi G. Diagnostic pathways and clinical significance of desquamative gingivitis. J Periodontol. 2008;79(1):4–24.CrossRefPubMedPubMedCentralGoogle Scholar
  70. Lo Russo L, Fierro G, Guiglia R, Compilato D, Testa NF, Lo Muzio L, Campisi G. Epidemiology of desquamative gingivitis: evaluation of 125 patients and review of the literature. Int J Dermatol. 2009;48(10):1049–52.CrossRefPubMedPubMedCentralGoogle Scholar
  71. Lodi G, Porter S. Management of potentially malignant disorders: evidence and critique. J Oral Pathol Med. 2008;37(2):63–9.CrossRefGoogle Scholar
  72. Lourenco SV, de Carvalho FR, Boggio P, Sotto MN, Vilela MA, Rivitti EA, Nico MM. Lupus erythematosus: clinical and histopathological study of oral manifestations and immunohistochemical profile of the inflammatory infiltrate. J Cutan Pathol. 2007;34(7):558–64.CrossRefGoogle Scholar
  73. Madani FM, Kuperstein AS. Normal variations of oral anatomy and common oral soft tissue lesions: evaluation and management. Med Clin North Am. 2014;98(6):1281–98.CrossRefGoogle Scholar
  74. Maia HC, Pinto NA, Pereira Jdos S, de Medeiros AM, da Silveira EJ, Miguel MC. Potentially malignant oral lesions: clinicopathological correlations. Einstein (Sao Paulo). 2016;14(1):35–40.CrossRefGoogle Scholar
  75. Manabe M, Lim HW, Winzer M, Loomis CA. Architectural organization of filiform papillae in normal and black hairy tongue epithelium: dissection of differentiation pathways in a complex human epithelium according to their patterns of keratin expression. Arch Dermatol. 1999;135(2):177–81.CrossRefGoogle Scholar
  76. Martinez-Useros J, Garcia-Foncillas J. The challenge of blocking a wider family members of EGFR against head and neck squamous cell carcinomas. Oral Oncol. 2015;51(5):423–30.CrossRefGoogle Scholar
  77. Mashberg A, Feldman LJ. Clinical criteria for identifying early oral and oropharyngeal carcinoma: erythroplasia revisited. Am J Surg. 1988;156(4):273–5.CrossRefGoogle Scholar
  78. Mays JW, Fassil H, Edwards DA, Pavletic SZ, Bassim CW. Oral chronic graft-versus-host disease: current pathogenesis, therapy, and research. Oral Dis. 2013;19(4):327–46.PubMedCentralCrossRefPubMedGoogle Scholar
  79. Miloglu O, Goregen M, Akgul HM, Acemoglu H. The prevalence and risk factors associated with benign migratory glossitis lesions in 7619 Turkish dental outpatients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107(2):e29–33.CrossRefGoogle Scholar
  80. More CB, Das S, Patel H, Adalja C, Kamatchi V, Venkatesh R. Proposed clinical classification for oral submucous fibrosis. Oral Oncol. 2012;48(3):200–2.CrossRefGoogle Scholar
  81. Mostefaoui Y, Claveau I, Ross G, Rouabhia M. Tissue structure, and IL-1beta, IL-8, and TNF-alpha secretions after contact by engineered human oral mucosa with dentifrices. J Clin Periodontol. 2002;29(11):1035–41.CrossRefGoogle Scholar
  82. Moura MD, Haddad JP, Senna MI, Ferreira e Ferreira E, Mesquita RA. A new topical treatment protocol for oral hairy leukoplakia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110(5):611–7.CrossRefGoogle Scholar
  83. Murti PR, Bhonsle RB, Pindborg JJ, Daftary DK, Gupta PC, Mehta FS. Malignant transformation rate in oral submucous fibrosis over a 17-year period. Community Dent Oral Epidemiol. 1985;13(6):340–1.CrossRefGoogle Scholar
  84. Nair U, Bartsch H, Nair J. Alert for an epidemic of oral cancer due to use of the betel quid substitutes gutkha and pan masala: a review of agents and causative mechanisms. Mutagenesis. 2004;19(4):251–62.CrossRefGoogle Scholar
  85. Napier SS, Cowan CG, Gregg TA, Stevenson M, Lamey PJ, Toner PG. Potentially malignant oral lesions in Northern Ireland: size (extent) matters. Oral Dis. 2003;9(3):129–37.CrossRefGoogle Scholar
  86. Natarajan E, Woo SB. Benign alveolar ridge keratosis (oral lichen simplex chronicus): a distinct clinicopathologic entity. J Am Acad Dermatol. 2008;58(1):151–7.CrossRefGoogle Scholar
  87. Naveen-Kumar B, Tatapudi R, Sudhakara-Reddy R, Alapati S, Pavani K, Sai-Praveen KN. Various forms of tobacco usage and its associated oral mucosal lesions. J Clin Exp Dent. 2016;8(2):e172–7.PubMedCentralPubMedGoogle Scholar
  88. Nico MM, Vilela MA, Rivitti EA, Lourenco SV. Oral lesions in lupus erythematosus: correlation with cutaneous lesions. Eur J Dermatol. 2008;18(4):376–81.Google Scholar
  89. Nico MM, Romiti R, Lourenco SV. Oral lesions in four cases of subacute cutaneous lupus erythematosus. Acta Derm Venereol. 2011;91(4):436–9.CrossRefGoogle Scholar
  90. Ohman SC, Dahlen G, Moller A, Ohman A. Angular cheilitis: a clinical and microbial study. J Oral Pathol. 1986;15(4):213–7.CrossRefGoogle Scholar
  91. Parashar P. Proliferative verrucous leukoplakia: an elusive disorder. J Evid Based Dent Pract. 2014;14(Suppl):147–153.e141.CrossRefGoogle Scholar
  92. Pavletic SZ, Fowler DH. Are we making progress in GVHD prophylaxis and treatment? Hematology Am Soc Hematol Educ Program. 2012;2012:251–64.Google Scholar
  93. Pindborg JJ, Murti PR, Bhonsle RB, Gupta PC, Daftary DK, Mehta FS. Oral submucous fibrosis as a precancerous condition. Scand J Dent Res. 1984;92(3):224–9.Google Scholar
  94. Pinto A, Haberland CM, Baker S. Pediatric soft tissue oral lesions. Dent Clin N Am. 2014;58(2):437–53.CrossRefGoogle Scholar
  95. Ponti G, Meschieri A, Pollio A, Ruini C, Manfredini M, Longo C, Mandel VD, Ciardo S, Tomasi A, Giannetti L, Pellacani G. Fordyce granules and hyperplastic mucosal sebaceous glands as distinctive stigmata in Muir-Torre syndrome patients: characterization with reflectance confocal microscopy. J Oral Pathol Med. 2015;44(7):552–7.CrossRefGoogle Scholar
  96. Rajalalitha P, Vali S. Molecular pathogenesis of oral submucous fibrosis – a collagen metabolic disorder. J Oral Pathol Med. 2005;34(6):321–8.CrossRefGoogle Scholar
  97. Ramulu C, Raju MV, Venkatarathnam G, Reddy CR. Nicotine stomatitis and its relation to carcinoma of the hard palate in reverse smokers of chuttas. J Dent Res. 1973;52(4):711–8.CrossRefGoogle Scholar
  98. Ranganathan K, Devi MU, Joshua E, Kirankumar K, Saraswathi TR. Oral submucous fibrosis: a case-control study in Chennai, South India. J Oral Pathol Med. 2004;33(5):274–7.CrossRefGoogle Scholar
  99. Ranginwala AM, Chalishazar MM, Panja P, Buddhdev KP, Kale HM. Oral discoid lupus erythematosus: a study of twenty-one cases. J Oral Maxillofac Pathol. 2012;16(3):368–73.PubMedCentralCrossRefPubMedGoogle Scholar
  100. Reichart PA, Philipsen HP. Oral erythroplakia – a review. Oral Oncol. 2005;41(6):551–61.CrossRefGoogle Scholar
  101. Reichart PA, Samaranayake LP, Philipsen HP. Pathology and clinical correlates in oral candidiasis and its variants: a review. Oral Dis. 2000;6(2):85–91.CrossRefGoogle Scholar
  102. Rodu B, Cole P. Smokeless tobacco use and cancer of the upper respiratory tract. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93(5):511–5.CrossRefGoogle Scholar
  103. Rosin MP, Cheng X, Poh C, Lam WL, Huang Y, Lovas J, Berean K, Epstein JB, Priddy R, Le ND, Zhang L. Use of allelic loss to predict malignant risk for low-grade oral epithelial dysplasia. Clin Cancer Res. 2000;6(2):357–62.Google Scholar
  104. Rugg EL, McLean WH, Allison WE, Lunny DP, Macleod RI, Felix DH, Lane EB, Munro CS. A mutation in the mucosal keratin K4 is associated with oral white sponge nevus. Nat Genet. 1995;11(4):450–2.CrossRefPubMedPubMedCentralGoogle Scholar
  105. Rullo OJ, Tsao BP. Recent insights into the genetic basis of systemic lupus erythematosus. Ann Rheum Dis. 2013;72(Suppl 2):ii56–61.CrossRefGoogle Scholar
  106. Sanchis JM, Bagan JV, Gavalda C, Murillo J, Diaz JM. Erythema multiforme: diagnosis, clinical manifestations and treatment in a retrospective study of 22 patients. J Oral Pathol Med. 2010;39(10):747–52.CrossRefGoogle Scholar
  107. Sarode GS, Batra A, Sarode SC, Yerawadekar S, Patil S. Oral cancer-related inherited cancer syndromes: a comprehensive review. J Contemp Dent Pract. 2016;17(6):504–10.CrossRefGoogle Scholar
  108. Saunders WH. Nicotine stomatitis of the palate. Ann Otol Rhinol Laryngol. 1958;67(3):618–27.CrossRefGoogle Scholar
  109. Savage SA. Dyskeratosis Congenita. In: Pagon RA, Adam MP, Ardinger HH, et al., editors. GeneReviews(R). Seattle: University of Washington; 1993. GeneReviews is a registered trademark of the University of Washington, Seattle. All rights reserved.Google Scholar
  110. Schalock PC, Dinulos JG, Pace N, Schwarzenberger K, Wenger JK. Erythema multiforme due to Mycoplasma pneumoniae infection in two children. Pediatr Dermatol. 2006;23(6):546–55.CrossRefGoogle Scholar
  111. Schiodt M, Larsen V, Bessermann M. Oral findings in glassblowers. Community Dent Oral Epidemiol. 1980;8(4):195–200.CrossRefGoogle Scholar
  112. Schofield JK, Tatnall FM, Brown J, McCloskey D, Navarrete C, Leigh IM. Recurrent erythema multiforme: tissue typing in a large series of patients. Br J Dermatol. 1994;131(4):532–5.CrossRefGoogle Scholar
  113. Scully C, Bagan JV. Oral squamous cell carcinoma: overview of current understanding of aetiopathogenesis and clinical implications. Oral Dis. 2009;15(6):388–99.CrossRefGoogle Scholar
  114. Scully C, Porter SR. The clinical spectrum of desquamative gingivitis. Semin Cutan Med Surg. 1997;16(4):308–13.CrossRefGoogle Scholar
  115. Setterfield JF, Neill S, Shirlaw PJ, Theron J, Vaughan R, Escudier M, Challacombe SJ, Black MM. The vulvovaginal gingival syndrome: a severe subgroup of lichen planus with characteristic clinical features and a novel association with the class II HLA DQB1*0201 allele. J Am Acad Dermatol. 2006;55(1):98–113.CrossRefGoogle Scholar
  116. Shafer WG, Waldron CA. Erythroplakia of the oral cavity. Cancer. 1975;36(3):1021–8.CrossRefGoogle Scholar
  117. Shah AY, Doherty SD, Rosen T. Actinic cheilitis: a treatment review. Int J Dermatol. 2010;49(11):1225–34.CrossRefGoogle Scholar
  118. Sharon V, Fazel N. Oral candidiasis and angular cheilitis. Dermatol Ther. 2010;23(3):230–42.PubMedCentralCrossRefPubMedGoogle Scholar
  119. Shibuya Y, Zhang J, Yokoo S, Umeda M, Komori T. Constitutional mutation of keratin 13 gene in familial white sponge nevus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96(5):561–5.CrossRefPubMedPubMedCentralGoogle Scholar
  120. Slots J, Saygun I, Sabeti M, Kubar A. Epstein-Barr virus in oral diseases. J Periodontal Res. 2006;41(4):235–44.CrossRefGoogle Scholar
  121. Smith AJ, Robertson D, Tang MK, Jackson MS, MacKenzie D, Bagg J. Staphylococcus aureus in the oral cavity: a three-year retrospective analysis of clinical laboratory data. Br Dent J. 2003;195(12):701–3; discussion 694.CrossRefGoogle Scholar
  122. Solomon LW, Wein RO, Rosenwald I, Laver N. Plasma cell mucositis of the oral cavity: report of a case and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(6):853–60.CrossRefGoogle Scholar
  123. Songu M, Adibelli H, Diniz G. White sponge nevus: clinical suspicion and diagnosis. Pediatr Dermatol. 2012;29(4):495–7.CrossRefGoogle Scholar
  124. Sontheimer RD. Subacute cutaneous lupus erythematosus: 25-year evolution of a prototypic subset (subphenotype) of lupus erythematosus defined by characteristic cutaneous, pathological, immunological, and genetic findings. Autoimmun Rev. 2005;4(5):253–63.CrossRefGoogle Scholar
  125. Spencer A, Gazzani P, Thompson DA. Acrylate and methacrylate contact allergy and allergic contact disease: a 13-year review. Contact Dermatitis. 2016;75(3):157–64.CrossRefGoogle Scholar
  126. Stojanov IJ, Woo SB. Human papillomavirus and Epstein-Barr virus associated conditions of the oral mucosa. Semin Diagn Pathol. 2015;32(1):3–11.PubMedCentralCrossRefPubMedGoogle Scholar
  127. Stransky N, Egloff AM, Tward AD, Kostic AD, Cibulskis K, Sivachenko A, Kryukov GV, Lawrence MS, Sougnez C, McKenna A, Shefler E, Ramos AH, Stojanov P, Carter SL, Voet D, Cortés ML, Auclair D, Berger MF, Saksena G, Guiducci C, Onofrio RC, Parkin M, Romkes M, Weissfeld JL, Seethala RR, Wang L, Rangel-Escareño C, Fernandez-Lopez JC, Hidalgo-Miranda A, Melendez-Zajgla J, Winckler W, Ardlie K, Gabriel SB, Meyerson M, Lander ES, Getz G, Golub TR, Garraway LA, Grandis JR. The mutational landscape of head and neck squamous cell carcinoma. Science. 2011;333(6046):1157–60.PubMedCentralCrossRefPubMedGoogle Scholar
  128. Sturgis EM, Cinciripini PM. Trends in head and neck cancer incidence in relation to smoking prevalence: an emerging epidemic of human papillomavirus-associated cancers? Cancer. 2007;110(7):1429–35.CrossRefGoogle Scholar
  129. Sun Y, Chan RK, Tan SH, Ng PP. Detection and genotyping of human herpes simplex viruses in cutaneous lesions of erythema multiforme by nested PCR. J Med Virol. 2003;71(3):423–8.CrossRefPubMedPubMedCentralGoogle Scholar
  130. Suresh L, Neiders ME. Definitive and differential diagnosis of desquamative gingivitis through direct immunofluorescence studies. J Periodontol. 2012;83(10):1270–8.PubMedCentralCrossRefPubMedGoogle Scholar
  131. Tatnall FM, Schofield JK, Leigh IM. A double-blind, placebo-controlled trial of continuous acyclovir therapy in recurrent erythema multiforme. Br J Dermatol. 1995;132(2):267–70.CrossRefGoogle Scholar
  132. Tejani S, Sultan A, Stojanov I, Woo SB. Candidal carriage predicts candidiasis during topical immunosuppressive therapy: a preliminary retrospective cohort study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;122(4):448–54.CrossRefGoogle Scholar
  133. Tilakaratne WM, Klinikowski MF, Saku T, Peters TJ, Warnakulasuriya S. Oral submucous fibrosis: review on aetiology and pathogenesis. Oral Oncol. 2006;42(6):561–8.CrossRefGoogle Scholar
  134. Treister NS, Stevenson K, Kim H, Woo SB, Soiffer R, Cutler C. Oral chronic graft-versus-host disease scoring using the NIH consensus criteria. Biol Blood Marrow Transplant. 2010;16(1):108–14.CrossRefGoogle Scholar
  135. Tsokos GC. Systemic lupus erythematosus. N Engl J Med. 2011;365(22):2110–21.CrossRefGoogle Scholar
  136. U.S. Department of Health and Human Services. The health consequences of smoking – 50 years of progress: a report of the surgeon general. Atlanta: U.S. Department of Health and Human Services, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.Google Scholar
  137. Vogelsang GB, Lee L, Bensen-Kennedy DM. Pathogenesis and treatment of graft-versus-host disease after bone marrow transplant. Annu Rev Med. 2003;54:29–52.CrossRefGoogle Scholar
  138. van der Eb MM, Leyten EM, Gavarasana S, Vandenbroucke JP, Kahn PM, Cleton FJ. Reverse smoking as a risk factor for palatal cancer: a cross-sectional study in rural Andhra Pradesh, India. Int J Cancer. 1993;54(5):754–8.CrossRefGoogle Scholar
  139. van der Meij EH, van der Waal I. Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications. J Oral Pathol Med. 2003;32(9):507–12.CrossRefGoogle Scholar
  140. van Monsjou HS, Wreesmann VB, van den Brekel MW, Balm AJ. Head and neck squamous cell carcinoma in young patients. Oral Oncol. 2013;49(12):1097–102.CrossRefGoogle Scholar
  141. van der Waal I. Potentially malignant disorders of the oral and oropharyngeal mucosa; terminology, classification and present concepts of management. Oral Oncol. 2009;45(4–5):317–23.CrossRefGoogle Scholar
  142. van der Waal I. Oral leukoplakia, the ongoing discussion on definition and terminology. Med Oral Patol Oral Cir Bucal. 2015;20(6):e685–92.PubMedCentralCrossRefPubMedGoogle Scholar
  143. Waldron CA, Shafer WG. Leukoplakia revisited. A clinicopathologic study 3256 oral leukoplakias. Cancer. 1975;36(4):1386–92.CrossRefGoogle Scholar
  144. Walling DM, Flaitz CM, Nichols CM. Epstein-Barr virus replication in oral hairy leukoplakia: response, persistence, and resistance to treatment with valacyclovir. J Infect Dis. 2003;188(6):883–90.CrossRefGoogle Scholar
  145. Warnakulasuriya S, Kerr AR. Oral submucous fibrosis: a review of the current management and possible directions for novel therapies. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;122(2):232–41.CrossRefGoogle Scholar
  146. Warnakulasuriya S, Sutherland G, Scully C. Tobacco, oral cancer, and treatment of dependence. Oral Oncol. 2005;41(3):244–60.CrossRefGoogle Scholar
  147. Warnakulasuriya S, Johnson NW, Van Der Waal I. Nomenclature and classification of potentially malignant disorders of the oral mucosa. J Oral Pathol Med. 2007;36(10):575–80.CrossRefGoogle Scholar
  148. Winn DM, Blot WJ, Shy CM, Pickle LW, Toledo A, Fraumeni Jr JF. Snuff dipping and oral cancer among women in the southern United States. N Engl J Med. 1981;304(13):745–9.CrossRefGoogle Scholar
  149. Woo S-B. Oral pathology a Comprehensive atlas and text with EXPERT CONSULT – online and print. London: Elsevier Health Sciences; 2012.Google Scholar
  150. Woo SB, Lin D. Morsicatio mucosae oris – a chronic oral frictional keratosis, not a leukoplakia. J Oral Maxillofac Surg. 2009;67(1):140–6.CrossRefGoogle Scholar
  151. Woo SB, Cashman EC, Lerman MA. Human papillomavirus-associated oral intraepithelial neoplasia. Mod Pathol. 2013;26(10):1288–97.CrossRefGoogle Scholar
  152. Woo SB, Grammer RL, Lerman MA. Keratosis of unknown significance and leukoplakia: a preliminary study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;118(6):713–24.CrossRefGoogle Scholar
  153. Wyss AB, Hashibe M, Lee YA, Chuang SC, Muscat J, Chen C, Schwartz SM, Smith E, Zhang ZF, Morgenstern H, Wei Q, Li G, Kelsey KT, McClean M, Winn DM, Schantz S, Yu GP, Gillison ML, Zevallos JP, Boffetta P, Olshan AF. Smokeless tobacco use and the risk of head and neck cancer: pooled analysis of US studies in the INHANCE consortium. Am J Epidemiol. 2016; 184(10):703–716.Google Scholar
  154. Yoithapprabhunath TR, Maheswaran T, Dineshshankar J, Anusushanth A, Sindhuja P, Sitra G. Pathogenesis and therapeutic intervention of oral submucous fibrosis. J Pharm Bioallied Sci. 2013;5(Suppl 1):S85–8.PubMedCentralCrossRefPubMedGoogle Scholar
  155. Yuan A, Woo SB. Adverse drug events in the oral cavity. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;119(1):35–47.PubMedCentralCrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Maryam Jessri
    • 1
    • 2
    • 5
  • Hani Mawardi
    • 4
    • 1
  • Camile S. Farah
    • 3
    Email author
  • Sook-Bin Woo
    • 1
    • 2
  1. 1.Division of Oral Medicine and DentistryBrigham and Women’s HospitalBostonUSA
  2. 2.Department of Oral Medicine, Infection and ImmunityHarvard School of Dental MedicineBostonUSA
  3. 3.UWA Dental School and Oral Health Centre of Western AustraliaFaculty of Health and Medical Sciences, University of Western AustraliaPerthAustralia
  4. 4.Faculty of DentistryKing Abdulaziz universityJeddahSaudi Arabia
  5. 5.UWA Dental School and Oral Health Centre of Western AustraliaUniversity of Western AustraliaPerthAustralia

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