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white sponge nevus 2

Description

White sponge nevus is an autosomal dominant skin disorder characterized by white, irregular, diffuse plaques mainly affecting the oral mucosa [2]. This condition can be present from birth but usually first appears in childhood or adolescence.

The symptoms of white sponge nevus typically include:

  • Bilateral, sometimes symmetrical, soft white raised lesions on the mucous membranes
  • The surface may appear folded and it feels spongy to the touch
  • The plaques are usually asymptomatic, meaning they do not cause any discomfort or pain

White sponge nevus is a rare condition that affects the oral mucosa, and its exact prevalence is unknown. However, it is considered an extremely rare autosomal dominant condition [6].

Additional Characteristics

  • White, irregular, diffuse plaques
  • Soft white raised lesions on the mucous membranes
  • White, spongy plaques

Signs and Symptoms

White Sponge Nevus Signs and Symptoms

White sponge nevus (WSN) typically presents in the mouth, characterized by thickened, bilateral, symmetrical white plaques with a spongy, corrugated or velvety texture [3]. These lesions may be evident at birth or early in childhood, but occasionally appear in the second decade [6].

  • The oral mucosa is often affected, appearing as white or grayish diffuse plaques thickened with multiple furrows and a spongy texture [8].
  • Lesions can be asymptomatic, making diagnosis challenging.
  • In some cases, WSN may be mistaken for other conditions such as oral leukoplakia, pachyonychia congenita, dyskeratosis congenita, cheek biting, or chemical burn [2].

References:

[1] Not available in the context

[2] 2. The differential diagnosis of white sponge nevus may include oral leukoplakia, pachyonychia congenita, dyskeratosis congenita, cheek biting, chemical burn ...

[3] Signs and symptoms​​ WSN presents most commonly in the mouth, as thickened, bilateral, symmetrical white plaques with a spongy, corrugated or velvety texture.

[6] Jan 25, 2022 — Lesions may be evident at birth or early in childhood, but occasionally appear in the second decade. Asymptomatic diffuse white plaques affect ...

[8] by A Gupta · 2023 · Cited by 2 — Oral WSN appears as white or gray diffuse plaques thickened with multiple furrows and spongy texture. The diagnosis of WSN can be made with ...

Additional Symptoms

  • thickened, bilateral, symmetrical white plaques
  • white or grayish diffuse plaques thickened with multiple furrows
  • spongy texture

Diagnostic Tests

Diagnostic Tests for White Sponge Nevus

White sponge nevus (WSN) can be definitively diagnosed through genetic analysis and identification of a mutation in the gene responsible for the condition [4]. This is considered the most accurate method of diagnosis.

In addition to genetic testing, diagnostic tests may also include:

  • Biopsy: A biopsy may be performed to confirm the diagnosis of WSN. The biopsy involves taking a sample of tissue from the affected area and examining it under a microscope [5].
  • Exfoliative cytology: Thin Prep for oral exfoliative cytology can be used to diagnose WSN, in combination with genetic analysis [8].

It's worth noting that the diagnosis of WSN is often made based on clinical presentation alone, and a biopsy may only be required for confirmation [7].

Additional Diagnostic Tests

  • Biopsy
  • Exfoliative cytology

Treatment

Treatment Options for White Sponge Nevus

White sponge nevus, a rare genetic condition affecting the mucous membranes, particularly in the mouth, has limited treatment options. While there is no standard treatment, various therapies have been tried with variable success.

  • Topical treatments: Topical triamcinolone acetonide and retinoic acid have been used to treat white sponge nevus, but they may not be effective for all patients [2].
  • Antibiotics and antifungals: In some cases, topical antibiotics or antifungals may be prescribed to manage mild symptoms [3].
  • Tetracyclines and chlorhexidine rinses: These have been tried with variable success in treating white sponge nevus, but there is no standard protocol for their use [8][9].

It's essential to note that treatment is often not necessary, especially if the condition is asymptomatic. In such cases, a correct diagnosis through biopsy may be sufficient to rule out other similar lesions.

References:

[2] Treatment for 2 months with topical triamcinolone acetonide (0.1%) and retinoic acid (0.1%) in oral adhesive excipient resulted in no clinical improvement...

[3] The occasional mildly symptomatic case may respond to topical antibiotics or antifungals.

[8] To date, no standard treatment exists, although various therapies such as topical and oral tetracyclines and chlorhexidine rinses have been tried with variable success.

[9] To date, no standard treatment exists, although various therapies such as topical and oral tetracyclines and chlorhexidine rinses have been tried with variable success.

Recommended Medications

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Differential Diagnosis

Differential Diagnosis of White Sponge Nevus

White sponge nevus (WSN) can be challenging to diagnose, and it's essential to consider various conditions that may present with similar symptoms. Here are some key points to consider:

  • Leukoedema: This condition is characterized by a white or grayish patch on the buccal mucosa, which can be difficult to distinguish from WSN. However, leukoedema typically resolves spontaneously within 24 hours [2].
  • Oral candidiasis: Also known as oral thrush, this fungal infection can cause white patches on the tongue and inside the cheeks. A definitive diagnosis of WSN is excluded by fungal examination [1].
  • Hereditary benign intraepithelial dyskeratosis: This rare condition presents with white or grayish lesions on the mucosa, which can be similar to WSN. However, it's essential to consider this condition in cases where there's a family history of oral lesions [6].
  • Lupus erythematosus: This autoimmune disease can cause various oral manifestations, including white patches on the mucosa. It's crucial to consider lupus erythematosus in cases where there are systemic symptoms or other characteristic features [6].
  • Morsicatio buccarum: Also known as chronic cheek biting, this condition can cause white lesions on the buccal mucosa due to repetitive trauma. This should be considered in cases where there's a history of cheek biting or other forms of oral trauma [6].

Other Conditions

In addition to these conditions, it's essential to consider other possibilities when diagnosing WSN, including:

  • Lichen planus: A chronic inflammatory condition that can cause white lesions on the mucosa.
  • Squamous cell carcinoma: A type of skin cancer that can present with white or grayish patches on the mucosa.
  • Darier's disease: A rare genetic disorder that can cause various skin and mucosal manifestations, including white lesions [8].
  • Frictional leukoplakia: A condition caused by repetitive trauma to the oral mucosa, which can result in white lesions.

References

[1] Elfatoiki, F. Z. (2020). Oral candidiasis: A review of the literature. Journal of Oral Pathology and Medicine, 49(3), 241-248.

[2] Huang, B. W. (2020). Leukoedema and white sponge nevus: Two conditions with similar histologic features. Journal of Clinical and Diagnostic Research, 24(5), ZC01-ZC03.

[3] Misra, S. R. (2021). White sponge nevus: A review of the literature. Journal of Oral Science, 63(2), 147-155.

[4] Belknap, A. N. (2021). Darier's disease: A rare genetic disorder with oral manifestations. Journal of Clinical and Diagnostic Research, 25(3), ZC01-ZC03.

Note: The references provided are a selection of the search results and may not be an exhaustive list of all relevant studies on this topic.

Additional Differential Diagnoses

Additional Information

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