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Skin-Melanocytic tumors
White sponge nevus
Author: Nat Pernick, M.D., PathologyOutlines.com, Inc.
Revised: 5 July 2009, last major update November 2008
Copyright: (c) 2005-2009, PathologyOutlines.com, Inc.
Definition
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● Rare, typically autosomal dominant disorder due to mutation in mucosal keratins CK4 (Br J Dermatol 2003;148:1125) and CK13 (J Dent Res 2001;80:919)
● Primarily affects nonkeratinized stratified squamous epithelium
● First described by Cannon in 1935 (Arch Dermatol Syphilol 1935;31:365)
Case reports
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● 33 year old with buccal lesion, no family history (Dermatol Online J 2008;14(5):16, link)
Treatment and prognosis
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● No standard treatment
● Possibly tetracycline
● Progression usually stops at puberty
● No malignant transformation
Clinical description
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● White to gray, diffuse, painless, spongy and folded plaques on buccal mucosa
Clinical images
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White plaques on buccal mucosa White plaques on tongue
Micro description
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● Parakeratosis, acanthosis with formation of large blunt rete ridges, spongiosis
● Extensive vacuolation of suprabasal keratinocytes
● Dyskeratotic cells exhibit dense peri- and paranuclear eosinophilic condensations, which correspond to tonofilament aggregates
● Abundant Odland bodies (keratinosome, membrane bound granule in upper stratum spinosum) within keratinocytes, but few are present in the intercellular spaces
Micro images
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Parakeratosis, acanthosis and spongiosis of mucosal epithelium with blunting of rete ridges; vacuolated and dyskeratotic epithelial keratinocytes demonstrate perinuclear eosinophilic condensations
End of Skin-Melanocytic Tumors > White sponge nevus
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