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return to: Laryngeal leukoplakia white plaques on vocal cords
see also: Overview of squamous dysplasia; Mild squamous dysplasia causing laryngeal leukoplakia
Hyperkeratosis is a mucosal abnormality in which dense orthokeratin accumulates on the mucosal surface. Among other causes, cigarette smoke and other inhalational irritants, induce the mucosa to "epidermalize" and it is frequently accompanied by the formation of a granular cell layer. Dysplasia, a precursor to carcinoma, can occur with or without hyperkeratosis. Biopsies of leukoplakic lesions are performed to exclude a dysplastic process.
Examples of hyperkeratosis |
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A dense layer of hyperkeratosis (braces) tops this mucosa, making it appear more skin-like rather than mucosal. |
This mucosa shows a dense granular cell layer (brackets) beneath dense orthokeratin. |
References
Woo SB. Oral Epithelial Dysplasia and Premalignancy. Head Neck Pathol. 2019 Sep;13(3):423-439. doi: 10.1007/s12105-019-01020-6. Epub 2019 Mar 18. PMID: 30887394; PMCID: PMC6684678.
Alabdulaaly L, Villa A, Chen T, Kerr A, Ross N, Abreu Alves F, Guollo A, Woo SB. Characterization of initial/early histologic features of proliferative leukoplakia and correlation with malignant transformation: a multicenter study. Mod Pathol. 2022 Aug;35(8):1034-1044. doi: 10.1038/s41379-022-01021-x. Epub 2022 Feb 19. PMID: 35184151.