Oral cavity
Inflammatory (noninfectious) lesions
Oral submucosal fibrosis

Author: Charu Thakral, M.D. (see Authors page)

Revised: 17 April 2018, last major update March 2013

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

PubMed Search: Oral submucosal fibrosis[TIAB]

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Cite this page: Thakral, C. Oral submucosal fibrosis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/oralcavityoralsubmucosalfibrosis.html. Accessed January 19th, 2019.
Definition / general
  • Mainly in India and Pakistan due to smokeless tobacco / chewing of betel quid
  • Reactive but risk factor for squamous cell carcinoma
  • Early lesions show blanching, mottled, marble-like appearance; later fibrous bands lead to stiffness, restricting ability to open mouth (trismus)
  • Buccal mucosa, lips, retromolar areas, soft palate
Case reports
  • None, irreversible once it develops
  • Cessation of quid chewing reduces risk of oral cancer but fibrosis is not altered
Clinical images

Images hosted on other servers:

Blanching and fibrosis

With verrucous leukoplakia

38 year old man:


After suturing graft

1 year followup

10 year old boy:

Difficulty in mouth opening

12 year old girl:

Shrunken uvula



Microscopic (histologic) description
  • Subepithelial fibrosis, chronic inflammation, often with eosinophils, hyalinization and loss of vascularity
  • Overlying epithelium is atrophic or hyperplastic and hyperkeratotic
Microscopic (histologic) images

Images hosted on other servers:

Dense fibrosis


Differential diagnosis