Squamous papilloma is also known with the name squamous cell papilloma. Squamous papilloma is a papilloma or a benign tumor-like outgrowth which develops from the squamous epithelial cells lining the surface of various organs and the skin.
These squamous epithelial cells are flat cells that are present in the outermost layer of the skin, the respiratory passages, the oral cavity, lowest part of alimentary canal, cervix, female genitalia, etc.
This Squamous papilloma is benign. It means that this tumor does not spread to other parts of the body by metastasis and the border of this tumorous outgrowth is well defined.
There are 2 main important types of Squamous papilloma, they are the oral squamous papilloma and the conjunctival squamous papilloma. Let us talk in depth about the Squamous papilloma that occurs in the mouth or oral cavity.
Causes of Squamous papilloma:
The main reason for the development of this benign tumor is a virus called HPV or Human papillomavirus. This virus is a DNA virus. It is called so because it integrates with the DNA of the humans. This virus infects the squamous epithelial cells and leads to their uncontrolled division.
This excessive cell division leads to the formation of papilloma in the mouth or oral cavity. This Squamous papilloma has round and sharp edges. The strains of the HPV virus responsible for the formation of this Squamous papilloma are HPV6 and HPV11.
These strains also cause warts like growths elsewhere in the body too like the genital regions and the cervix. HPV virus is not contagious. It doesn’t spread from one person to another person just by contact.
Symptoms of Squamous papilloma:
The Squamous papilloma of the oral cavity or mouth affects many parts of the mouth like lips, the inner surface of the cheeks and also the tongue. This benign tumor produces warts like growths inside the mouth.
They can affect people of any age group. But, most commonly they are seen in the people above the age of 30 years. They also affect men and women alike. They don’t occur with higher frequency in a particular gender.
The Squamous papilloma can occur as a single lesion in the mouth or there can be multiple lesions in the mouth. They are pink or red in color if the amount of keratin pigment in them is less. They are white in color if they have a higher content of keratin pigment.
These tumors called Squamous cell papilloma are wart-like projections. They have pointed ends. In the majority of the people, they are completely painless.
But, in some people, it can be very painful. The oral squamous papilloma is attached to a stalk-like structure at the bottom. If the size of the papilloma increases greatly and if it is present near the throat, it can cause difficulty in swallowing or dysphagia.
The size of these Squamous papillomas can range anywhere from half cm to 3 cms. Once they develop, they don’t reduce in size spontaneously.
Diagnosis of Squamous papilloma:
The diagnosis of Squamous cell papilloma is mainly based on physical examination. Your physician inspects your mouth and oral cavity to observe all the characteristics and appearance of these warts in a detailed manner.
He looks to see if there is a presence of any pink, red or white colored structures in the mouth. Pink or red colored finger-like projections appear due to having less keratin. White cauliflower like outgrowths in the oral cavity are seen due to a higher amount of certain in them.
The physician also notes the size of the benign papilloma. If it’s between 0.5 cm and 3 cm and it is attached to a stalk-like structure, then it is more likely to be a papilloma.
But, if your physician gets any doubt whether it’s benign or malignant cancer, then he might take a biopsy of the lesion or oral squamous papilloma and then send it to a laboratory. A pathologist investigates the biopsy specimen under a microscope and then gives an accurate report if it’s benign or malignant.
Treatment of Oral Squamous papilloma:
The necessity of the treatment of the Squamous papilloma is decided based on whether the lesion is benign or malignant. The treatment decision is also made based on whether it’s painful or not.
If the lesion is painless and doesn’t cause any discomfort, there is no need for the removal or treatment of this papilloma. It is just left alone.
But, if the Squamous papilloma is painful, causes difficulty swallowing, etc it is treated. If any report of malignancy comes out, then also it is treated.
There are many different modalities available for the treatment of this Squamous papilloma. It can be removed with a simple surgical excision of the head and the base of the tumorous growth.
Some agents to break down the keratin pigments called keratolytic agents can also be injected into the papilloma or can be applied topically. Some examples of such keratolytic agents are salicylic acid and lactic acid.
Some other drugs like imiquimod or alpha-interferon can also be injected into the lesion of papilloma. Another therapy called cryotherapy can also be tried over the Squamous papilloma. In cryotherapy, cold substances like liquid nitrogen are applied over the lesion. These cold substances freeze the lesion and damage it.
Prognosis of Squamous papilloma:
When removed once, the rate of recurrence of the Squamous cell papilloma is very less. But, in some people, the benign tumor might grow back. But, this recurrence is very rarely seen and that it occurs only in some people.
In some people, Squamous papilloma can grow in the conjunctiva also. The conjunctiva is the white layer covering the inner surface of the eyelids and also the white part of the eyeball called the sclera.
It generally occurs when the HPV viral infection is passed on from mother to the child through her vagina during childbirth. Then there is a development of conjunctival papilloma in kids and young adults.
The conjunctival papilloma is also caused by HPV6 and HPV 11 strains of the virus. It is also benign and painless. The treatment modalities of conjunctival papilloma are same as that of oral Squamous papilloma.