Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Head and Neck Pathology
Published in: Head and Neck Pathology 1/2019

01-03-2019 | Glossitis | Special Issue: Colors and Textures, a Review of Oral Mucosal Entities

Erythematous and Vascular Oral Mucosal Lesions: A Clinicopathologic Review of Red Entities

Authors: Kristin K. McNamara, John R. Kalmar

Published in: Head and Neck Pathology | Issue 1/2019

Login to get access

Abstract

Erythematous lesions of the oral mucosa are common and can reflect a variety of conditions, ranging from benign reactive or immunologically-mediated disorders to malignant disease. Together with vascular abnormalities, which can vary from reddish to bluish-purple in color, the differential diagnosis for erythematous oral mucosal change is quite diverse. This review focuses on salient clinical features and histopathologic findings of selected conditions which clinically present as red or vascular-like oral mucosal alterations, including oral vascular malformations and neoplasms, pyogenic granuloma, localized juvenile spongiotic gingival hyperplasia, denture stomatitis, benign migratory glossitis (geographic tongue), orofacial granulomatosis, granulomatosis with polyangiitis (Wegener granulomatosis), megaloblastic anemia, and erythroplakia. Recognition of the characteristic clinical features of these conditions, in conjunction with thorough patient history, will allow clinicians to narrow the differential diagnosis and guide appropriate clinical decision making, including the need for tissue biopsy, in order to complete the diagnostic process and initiate optimal patient care.
Literature
1.
Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg. 1982;69(3):412–22.PubMedCrossRef
2.
ISSVA Classification of Vascular Anomalies. ©2018 International Society for the Study of Vascular Anomalies Available at “issva.org/classification” Accessed 12 Oct 2018.
3.
Garzon MC, Huang JT, Enjolras O, Frieden IJ. Vascular malformations: Part I. J Am Acad Dermatol. 2007;56(3):353. quiz 371–4.PubMedCrossRef
4.
Fowell C, Verea Linares C, Jones R, Nishikawa H, Monaghan A. Venous malformations of the head and neck: current concepts in management. Br J Oral Maxillofac Surg. 2017;55(1):3–9.PubMedCrossRef
5.
Love Z, Hsu DP. Low-flow vascular malformations of the head and neck: clinicopathology and image guided therapy. J Neurointerv Surg. 2012;4(6):414–25.PubMedCrossRef
6.
Saravana GH. Oral pyogenic granuloma: a review of 137 cases. Br J Oral Maxillofac Surg. 2009;47(4):318–9.PubMedCrossRef
7.
Al-Khateeb T, Ababneh K. Oral pyogenic granuloma in Jordanians: a retrospective analysis of 108 cases. J Oral Maxillofac Surg. 2003;61(11):1285–8.PubMedCrossRef
8.
Chi AC, Weathers DR, Folpe AL, Dunlap DT, Rasenberger K, Neville BW. Epithelioid hemangioendothelioma of the oral cavity: report of two cases and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100(6):717–24.PubMedCrossRef
9.
Heera R, Cherian LM, Lav R, Ravikumar V. Hemangioendothelioma of palate: A case report with review of literature. J Oral Maxillofac Pathol. 2017;21(3):415–20.PubMedPubMedCentralCrossRef
10.
Agaimy A, Mueller SK, Harrer T, Bauer S, Thompson LDR. Head and neck kaposi sarcoma: clinicopathological analysis of 11 cases. Head Neck Pathol. 2018;5:1–6
11.
Fanburg-Smith JC, Furlong MA, Childers EL. Oral and salivary gland angiosarcoma: a clinicopathologic study of 29 cases. Mod Pathol. 2003;16(3):263–71.PubMedCrossRef
12.
Nagata M, Yoshitake Y, Nakayama H, Yoshida R, Kawahara K, Nakagawa Y, et al. Angiosarcoma of the oral cavity: a clinicopathological study and a review of the literature. Int J Oral Maxillofac Surg. 2014;43(8):917–23.PubMedCrossRef
13.
Ordonez NG. Immunohistochemical endothelial markers: a review. Adv Anat Pathol. 2012;19(5):281–95.PubMedCrossRef
14.
15.
Epivatianos A, Antoniades D, Zaraboukas T, Zairi E, Poulopoulos A, Kiziridou A, et al. Pyogenic granuloma of the oral cavity: comparative study of its clinicopathological and immunohistochemical features. Pathol Int. 2005;55(7):391–7.PubMedCrossRef
16.
Gordon-Nunez MA, de Vasconcelos Carvalho M, Benevenuto TG, Lopes MF, Silva LM, Galvao HC. Oral pyogenic granuloma: a retrospective analysis of 293 cases in a Brazilian population. J Oral Maxillofac Surg. 2010;68(9):2185–8.PubMedCrossRef
17.
Toida M, Hasegawa T, Watanabe F, Kato K, Makita H, Fujitsuka H, et al. Lobular capillary hemangioma of the oral mucosa: clinicopathological study of 43 cases with a special reference to immunohistochemical characterization of the vascular elements. Pathol Int. 2003;53(1):1–7.PubMedCrossRef
18.
Brieley DJ, Crane H, Hunter KD. Lumps and bumps of the gingiva: a pathological miscellany. Head Neck Pathol. (pending).
19.
Darling MR, Daley TD, Wilson A, Wysocki GP. Juvenile spongiotic gingivitis. J Periodontol. 2007;78(7):1235–40.PubMedCrossRef
20.
Allon I, Lammert KM, Iwase R, Spears R, Wright JM, Naidu A. Localized juvenile spongiotic gingival hyperplasia possibly originates from the junctional gingival epithelium-an immunohistochemical study. Histopathology. 2016;68(4):549–55.PubMedCrossRef
21.
Chang JY, Kessler HP, Wright JM. Localized juvenile spongiotic gingival hyperplasia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(3):411–8.PubMedCrossRef
22.
Siamantas I, Kalogirou EM, Tosios KI, Fourmousis I, Sklavounou A. Spongiotic gingival hyperplasia synchronously involving multiple sites: case report and review of the literature. Head Neck Pathol. 2018;6:1–5
23.
de Freitas Silva BS, Silva Sant’Ana SS, Watanabe S, Vencio EF, Roriz VM, Yamamoto-Silva FP. Multifocal red bands of the marginal gingiva. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;119(1):3–7.PubMedCrossRef
24.
Gendreau L, Loewy ZG. Epidemiology and etiology of denture stomatitis. J Prosthodont. 2011;20(4):251–60.PubMedCrossRef
25.
Barbeau J, Seguin J, Goulet JP, de Koninck L, Avon SL, Lalonde B, et al. Reassessing the presence of Candida albicans in denture-related stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95(1):51–9.PubMedCrossRef
26.
Aoun G, Cassia A. Evaluation of denture-related factors predisposing to denture stomatitis in a lebanese population. Mater Sociomed. 2016;28(5):392–6.PubMedPubMedCentralCrossRef
27.
Nanetti A, Stancari F, Ferri M, Mazzoni A. Relationship between Candida albicans and denture stomatitis: a clinical and microbiological study. New Microbiol. 1993;16(3):287–91.PubMed
28.
Hellstein JW. Candidiasis: diagnosis and management. Head Neck Pathol. (pending).
29.
Bergendal T, Isacsson G. A combined clinical, mycological and histological study of denture stomatitis. Acta Odontol Scand. 1983;41(1):33–44.PubMedCrossRef
30.
Gual-Vaques P, Jane-Salas E, Egido-Moreno S, Ayuso-Montero R, Mari-Roig A, Lopez-Lopez J. Inflammatory papillary hyperplasia: A systematic review. Med Oral Patol Oral Cir Bucal. 2017;22(1):e36–42.PubMed
31.
Thwaites MS, Jeter TE, Ajagbe O. Inflammatory papillary hyperplasia: review of literature and case report involving a 10-year-old child. Quintessence Int. 1990;21(2):133–8.PubMed
32.
Gual-Vaques P, Jane-Salas E, Mari-Roig A, Lopez-Lopez J. Inflammatory Papillary Hyperplasia in a Non-Denture-Wearing Patient: A Case History Report. Int J Prosthodont. 2017;30(1):80–2.PubMedCrossRef
33.
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.PubMedCrossRef
34.
Shulman JD, Carpenter WM. Prevalence and risk factors associated with geographic tongue among US adults. Oral Dis. 2006;12(4):381–6.PubMedCrossRef
35.
Yesudian PD, Chalmers RJ, Warren RB, Griffiths CE. In search of oral psoriasis. Arch Dermatol Res. 2012;304(1):1–5.PubMedCrossRef
36.
Fatahzadeh M, Schwartz RA. Oral psoriasis: an overlooked enigma. Dermatology. 2016;232(3):319–25.PubMedCrossRef
37.
Picciani BL, Domingos TA, Teixeira-Souza T, Santos Vde C, Gonzaga HF, Cardoso-Oliveira J, et al. Geographic tongue and psoriasis: clinical, histopathological, immunohistochemical and genetic correlation—a literature review. An Bras Dermatol. 2016;91(4):410–21.PubMedPubMedCentralCrossRef
38.
Lo Russo L, Fierro G, Guiglia R, Compilato D, Testa NF, Lo Muzio L, et al. Epidemiology of desquamative gingivitis: evaluation of 125 patients and review of the literature. Int J Dermatol. 2009;48(10):1049–52.PubMedCrossRef
39.
Suresh L, Neiders ME. Definitive and differential diagnosis of desquamative gingivitis through direct immunofluorescence studies. J Periodontol. 2012;83(10):1270–8.PubMedCrossRef
40.
Fitzpatrick SG, Cohen D, Clark A. Ulcerated lesions of the oral mucosa: clinical and histologic review. Head Neck Pathol. (pending).
41.
42.
Grave B, McCullough M, Wiesenfeld D. Orofacial granulomatosis—a 20-year review. Oral Dis. 2009;15(1):46–51.PubMedCrossRef
43.
44.
Saalman R, Mattsson U, Jontell M. Orofacial granulomatosis in childhood—a clinical entity that may indicate Crohn’s disease as well as food allergy. Acta Paediatr. 2009;98(7):1162–7.PubMedCrossRef
45.
Campbell H, Escudier M, Patel P, Nunes C, Elliott TR, Barnard K, et al. Distinguishing orofacial granulomatosis from crohn’s disease: two separate disease entities? Inflamm Bowel Dis. 2011;17(10):2109–15.PubMedCrossRef
46.
Lutalo PM, D’Cruz DP. Diagnosis and classification of granulomatosis with polyangiitis (aka Wegener’s granulomatosis). J Autoimmun. 2014;48–49:94–98.PubMedCrossRef
47.
Stewart C, Cohen D, Bhattacharyya I, Scheitler L, Riley S, Calamia K, et al. Oral manifestations of Wegener’s granulomatosis: a report of three cases and a literature review. J Am Dent Assoc. 2007;138(3):338.PubMedCrossRef
48.
Comarmond C, Cacoub P. Granulomatosis with polyangiitis (Wegener): clinical aspects and treatment. Autoimmun Rev. 2014;13(11):1121–5.PubMedCrossRef
49.
Ruokonen H, Helve T, Arola J, Hietanen J, Lindqvist C, Hagstrom J. “Strawberry like” gingivitis being the first sign of Wegener’s granulomatosis. Eur J Intern Med. 2009;20(6):651–3.PubMedCrossRef
50.
51.
Drummond JF, White DK, Damm DD. Megaloblastic anemia with oral lesions: a consequence of gastric bypass surgery. Oral Surg Oral Med Oral Pathol. 1985;59(2):149–53.PubMedCrossRef
52.
Greenberg MS. Clinical and histologic changes of the oral mucosa in pernicious anemia. Oral Surg Oral Med Oral Pathol. 1981;52(1):38–42.PubMedCrossRef
53.
Triantafillidou K, Dimitrakopoulos J, Iordanidis F, Gkagkalis A. Extranodal non-hodgkin lymphomas of the oral cavity and maxillofacial region: a clinical study of 58 cases and review of the literature. J Oral Maxillofac Surg. 2012;70(12):2776–85.PubMedCrossRef
54.
Epstein JB, Epstein JD, Le ND, Gorsky M. Characteristics of oral and paraoral malignant lymphoma: a population-based review of 361 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92(5):519–25.PubMedCrossRef
55.
Chowdhri K, Tandon S, Lamba AK, Faraz F. Leukemic gingival enlargement: A case report and review of literature. J Oral Maxillofac Pathol. 2018;22(Suppl 1):77–81.CrossRef
56.
57.
Lingen MW, Xiao W, Schmitt A, Jiang B, Pickard R, Kreinbrink P, et al. Low etiologic fraction for high-risk human papillomavirus in oral cavity squamous cell carcinomas. Oral Oncol. 2013;49(1):1–8.PubMedCrossRef
58.
Poling JS, Ma XJ, Bui S, Luo Y, Li R, Koch WM, et al. Human papillomavirus (HPV) status of non-tobacco related squamous cell carcinomas of the lateral tongue. Oral Oncol. 2014;50(4):306–10.PubMedPubMedCentralCrossRef
59.
60.
61.
Metadata
Title
Erythematous and Vascular Oral Mucosal Lesions: A Clinicopathologic Review of Red Entities
Authors
Kristin K. McNamara
John R. Kalmar
Publication date
01-03-2019
Publisher
Springer US
Published in
Head and Neck Pathology / Issue 1/2019
Electronic ISSN: 1936-0568
DOI
https://doi.org/10.1007/s12105-019-01002-8

Other articles of this Issue 1/2019

Head and Neck Pathology 1/2019 Go to the issue

Special Issue: Colors and Textures, a Review of Oral Mucosal Entities

A Rainbow of Colors and Spectrum of Textures: An Approach to Oral Mucosal Entities

Special Issue: Colors and Textures, a Review of Oral Mucosal Entities

Tongue Lumps and Bumps: Histopathological Dilemmas and Clues for Diagnosis

Special Issue: Colors and Textures, a Review of Oral Mucosal Entities

Frictional Keratosis, Contact Keratosis and Smokeless Tobacco Keratosis: Features of Reactive White Lesions of the Oral Mucosa

Special Issue: Colors and Textures, a Review of Oral Mucosal Entities

Candidiasis: Red and White Manifestations in the Oral Cavity

Special Issue: Colors and Textures, a Review of Oral Mucosal Entities

HPV-Related Papillary Lesions of the Oral Mucosa: A Review

Special Issue: Colors and Textures, a Review of Oral Mucosal Entities

A Guide to Yellow Oral Mucosal Entities: Etiology and Pathology