Vulva & female urethra
Nonneoplastic disorders
Squamous cell hyperplasia (keratosis) / leukoplakia

Topic Completed: 1 November 2013

Revised: 5 August 2019

Copyright: 2002-2019,, Inc.

PubMed Search: "Squamous cell" hyperplasia keratosis

Monika Roychowdhury, M.D.
Page views in 2018: 3,689
Page views in 2019 to date: 3,763
Cite this page: Roychowdhury M. Squamous cell hyperplasia (keratosis) / leukoplakia. website. Accessed October 21st, 2019.
Definition / general
  • Not an entity, only a description of a morphological alteration of vulvar skin
  • Squamous cell hyperplasaia related to chronic irritation
  • Does not appear to be precursor to HIV negative squamous cell carcinoma (Hum Pathol 1996;27:389)
  • Formerly called hyperplastic dystrophy or leukoplakia
  • Suggested to diagnose as dermatosis, not a squamous hyperplasia (Mod Pathol 1997;10:401)
Clinical features
  • 2/3 premenopausal
  • Pink red vulva with overlying gray white keratin
  • Pruritus followed by a cycle of itching, scrubbing and scratching
  • Diagnosis of exclusion on the basis of specific anatomical clinical features
Prognostic factors
  • May be observed next to invasive squamous cell cancer although risk of invasive cancer for women treated for squamous cell hyperplasia without intraepithelial neoplasia is minimal
  • Squamous cell hyperplasia occurring in a background of lichen sclerosus constitute a distinct group at higher risk of developing invasive cancer
  • Topical corticosteroids, fluorinated compounds in ointments relieve itching
Microscopic (histologic) description
  • Elongation, widening of the rete ridges and irregular thickening of the Malpighian layer of rete ridges (acanthosis); hyperkeratosis and chronic inflammation in dermis
  • May have increased mitotic figures in basal and prickle cell layers but no atypia
  • Parakeratosis may be present
Microscopic (histologic) images

AFIP images

Prostate: hyperkeratosis, papillomatosis, acanthosis

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