Incisional and excisional biopsy

The histology of both specimens was similar in that the epithelium showed evidence of hyperorthokeratosis (Figure 3) with melanin incontinence (Figure 4) and connective tissue fibrosis consistent with smoker’s keratosis.  One of the fragments had verrucoid hyperorthokeratosis.  The epithelium was well differentiated and showed no evidence of frank dysplasia. 

Figure 3. Low power (x100) histology shows a piece of oral mucosa with a thick orthokeratin layer and focal areas of acanthosis and connective tissue fibrosis with basal cell melanosis.

 

Figure 4. High power (x200) histology shows a piece of oral mucosa with the basal cell layer actively producing and releasing melanin.  There is evidence of mild acanthosis and connective tissue fibrosis