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White sponge nevus (WSN) is an uncommon disease chief complaint of white lesions in the oral cavity and lip
that Hyde first described in 1909, but Cannon (1) coined present since birth. His parents denied presence of a
the term in 1935. This entity is also known by other similar condition in immediate family members or any
names: Cannon’s disease, familial white folded dysplasia, similar lesions elsewhere on his body. Lesions never
hereditary leukokeratosis, white gingivostomatitis, and changed despite numerous interventions such as vita-
exfoliative leukoedema (2,3). mins, oral nystatin suspension, and long-term penicillin
The disorder may be detected in early childhood. The prophylaxis.
lesions are asymptomatic and are discovered inciden- On clinical examination, there were bilateral, sym-
tally. The involved mucosa is white or greyish, thickened, metrical white plaques and patches on the buccal and
folded, and spongy. Lesions are usually misdiagnosed as labial mucosa that could not be removed (Figs. 1 and
candidiasis in children, and the true nature of the disease 2A–C). The margins were well defined, and no lymph
is discovered when antifungal therapy fails. Correct nodes were palpable. Oral hygiene was adequate, and
diagnosis of WSN, which is a benign condition, should oral examination was normal. On histopathologic eval-
be established because other possible ‘‘white’’ lesions uation, thickened epidermis and vacuolization in kerat-
could have malignant potential. We herein present a case inocytes were noted (Fig. 3). Underlying connective
of WSN of the oral cavity in a patient with no history of tissue was normal in appearance. Based on clinical data
familial involvement and a review of the literature. and histopathologic findings, the lesion was consistent
with WSN. The lesions were resistant to tetracycline and
azithromycin treatments. Given that WSN can mimic
CASE REPORT
malignant lesions in the oral cavity, a biopsy and correct
A 16-year-old boy without significant medical history diagnosis is necessary to exclude other concerning
was referred to the outpatient clinic of our hospital with a lesions. Six-month follow-up was recommended.
DOI: 10.1111/j.1525-1470.2011.01414.x
A B C
Figure 2. (A) White spongy plaques on the lingual mucosa. (B) White spongy plaques on the right buccal mucosa. (C) White
spongy plaques on the left buccal mucosa.
Songu et al: White Sponge Nevus 3
REFERENCES
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Figure 3. Histopathologic view of the lesion. Thickened
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