Nonneoplastic disorders
Squamous cell hyperplasia (keratosis)

Author: Monika Roychowdhury, M.D. (see Authors page)

Revised: 4 October 2017, last major update November 2013

Copyright: (c) 2002-2017,, Inc.

PubMed Search: "Squamous cell" hyperplasia keratosis

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Cite this page: Roychowdhury, M. Squamous cell hyperplasia (keratosis). website. Accessed January 22nd, 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

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Prostate: hyperkeratosis, papillomatosis, acanthosis