Abstract
Background: The etiology of verrucous lesions of the oral cavity is debatable, and many western
studies attribute it to human papillomavirus (HPV) infection. Although most Indian
studies have found a strong association with tobacco chewing, the role of HPV has
not been studied in the Indian context. Materials and Methods: A prospective study was conducted on the clinicopathological profile of 21 consecutive
patients of verrucous lesions of the oral cavity. The patients were evaluated on the
basis of addictions, pretreatment biopsy, p16 immunohistochemistry (IHC), and histopathological
parameters. Results: Preoperative incisional biopsy revealed no dysplasia in 52.38%, mild-to-moderate
dysplasia in 19.04%, and invasive carcinoma in 28.57% of the patients. About 67% of
patients underwent surgical excision in our institute all of whom had invasive malignancy
on final histopathology. This included 42.85% patients whose initial biopsy was no
or mild dysplasia. All of the patients were negative for p16 IHC. Conclusions: Verrucous lesions in Indian population are caused by smokeless tobacco unlike that
in the western countries where HPV is the main etiology. Clinical distinction between
benign and malignant lesions is difficult, and we recommend complete surgical excision
of the lesion with adequate margins whenever possible.
Keywords
Human papillomavirus - oral cavity and human papillomavirus - p16 immunohistochemistry
- smokeless tobacco - verrucous lesions
