This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
To the Editor.—
I read with great interest the recent article entitled "Leukoedema of the Oral Mucosa: Possibly an Acquired White Sponge Nevus" by Duncan and Su in the August 1980 Archives (116:906-908). The kindest remark I can make is that the case they report simply is not leukoedema, but instead represents a reactive hyperkeratosis, probably secondary to chronic factitious biting trauma. True leukoedema is initially seen clinically as a bilaterally symmetrical, smooth-surfaced area with a classic grayish-opalescent tinge. The latter appearance, which incidentally can be diminished by stretching the mucosa, is thought to be caused by hydrated epithelial cells that tend to overlap more than in unaffected mucosa. The condition is congenital, is not a problem, and does not require treatment. The authors are referred to any of several standard oral pathology texts in which the true condition of leukoedema is described and illustrated.As unfortunate as it is,
Krutchkoff D. Leukoedema, Reactive Hyperkeratosis, or Cheek Biting. Arch Dermatol. 1981;117(8):454. doi:10.1001/archderm.1981.01650080006009