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Oral frictional hyperkeratosis - Oral Mucosal Lesion
Other Resources UpToDate PubMed

Oral frictional hyperkeratosis - Oral Mucosal Lesion

Contributors: Carl Allen DDS, MSD, Sook-Bin Woo MS, DMD, MMSc
Other Resources UpToDate PubMed


Oral frictional hyperkeratosis is a benign white lesion of the oral mucosa that is caused by chronic trauma to the site. This tends to occur in adults.

The area is asymptomatic.

This occurs on the maxillary and mandibular alveolar ridges particularly after extraction of teeth, and particularly in the area of extracted mandibular third molars on the retromolar pad area. The alveolar ridge mucosa that had previously been "protected" from food impingement is now exposed to trauma and becomes hyperkeratotic as a protective mechanism.

However, other sites may be affected depending on the circumstance. For example, a sharp or broken cusp that rubs against the buccal mucosa or lateral/ventral tongue may cause an area of hyperkeratosis.

These areas take months to develop and they persist as long as the traumatic events persist.

Related topic: Chronic cheek chewing


K13.79 – Other lesions of oral mucosa

235034000 – Oral frictional keratosis

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Differential Diagnosis & Pitfalls

  • Leukoplakia – This is the most important differential diagnosis. Because of the premalignant and malignant connotation of leukoplakia, and if you are in doubt, a biopsy should be undertaken.
  • Linea alba –This is a form of frictional keratosis seen on the buccal mucosa with a characteristic clinical appearance.
  • Chronic cheek chewing – This is another form of frictional keratosis that has a shaggy surface configuration.
  • Oral candidiasis – This is usually acute, tends to be surrounded by erythema, and is usually multifocal in presentation.
  • Oral lichen planus
  • Oral squamous cell carcinoma

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Last Updated:06/10/2018
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Oral frictional hyperkeratosis - Oral Mucosal Lesion
A medical illustration showing key findings of Oral frictional hyperkeratosis : Buccal mucosa, Oral white plaque
Clinical image of Oral frictional hyperkeratosis - imageId=2492737. Click to open in gallery.  caption: 'A subtle white papule on the lateral tongue.'
A subtle white papule on the lateral tongue.
Copyright © 2024 VisualDx®. All rights reserved.