Studies on oral submucous fibrosis. III. Epithelial changes

The literature on the epithelial changes in oral submucous fibrosis is reviewed. The epithelial changes seen in thirty-eight biopsy specimens from thirty-eight patients with oral submucous fibrosis are presented in detail. It was seen that in submucous fibrosis there is a tendency toward epithelial atrophy associated with hyperothokeratosis and pyknotic changes in the nuclei of the basal-cell layer. Hyperplasia of the epithelium usually associated with hyperparakeratosis was also noticed. A striking feature in this study was the absence of glycogen from most of the Grade III (severe) cases. Vacuolization of prickle-cell layer, increased mitotic activity, and epithelial atypia were also noticed in a few cases. The significance of submucous fibrosis as a possible precancerous lesion is emphasized, with reference to the recent reports in the literature.