Oral HPV Lesions

Comments:
HPV-induced oral and oropharyngeal lesions include: focal epithelial hyperplasia (Heck Disease), verruca vulgaris, condyloma acuminata, squamous papilloma as well as a subset of oral/oropharyngeal cancers.

The benign oral lesions are usually associated with HPV types 2, 4, 6, 11, 13, and 32. Malignant oral lesions are mostly caused by HPV types 16, 18, and 33. HPV DNA has been found in about 25% of oral cancers and 35% of pharyngeal cancers. Poorly-differentiated non-keratinizing squamous cell carcinomas of oropharynx (palatine and lingual tonsil) in sexually active young individuals have highest detection rates for HPV DNA. Immunostain for p16 (a surrogate markers for HPV) frequently shows block positivity in these cases.

HPV-associated oropharyngeal cancers frequently have a basaloid appearance and cystic lymph node metastases. They respond favorably to chemotherapy and radiation and have a better prognosis compared to non-HPV conventional squamous cell carcinomas of the head and neck region.

The image shows oral condyloma acuminata in a patient with HIV/AIDS.
Image courtesy of: CDC/Sol Silverman, Jr., DDS.