Hyperkeratotic lesions on oral mucosal surfaces
that are normally keratinized, such as dorsum of
the tongue, hard palate, and attached gingiva,
sometimes represent a physiologic response
(callus) to chronic irritation. These lesions will
usually resolve if the irritant is removed and
may not require biopsy when first detected.
Hyperkeratotic lesions on surfaces that are
normally nonkeratinized are potentially more
serious and should be biopsied if they do not
resolve if irritants are removed. Remember,
however, that dysplasia, carcinoma in situ, and
squamous cell carcinoma can occur on any oral
mucosal surface.