Morsicatio buccarum K13.6

Harmless calluses of the mucous membranes, especially on the cheeks, which are caused by habitual cheek chewing (so-called habits) or pleasurable retraction of the mucous membranes of the cheeks, processes which may develop in children and adults into a habitual compulsive reaction to stress or other discomfort.

Combination with cheilophagy (lip chewing) is possible, see also artifacts.

Strip-shaped chewed, whitish or spotty, reddened, blurred plaques in the area of the buccal mucosa with ragged lesions in the area of the tooth closing ridge. In addition, focal bleeding and erosions also occur. The anterior buccal interdental line is particularly affected, as the retro-angular area can be sucked between the teeth particularly easily.

Irregular plump acanthosis with focal, racy ortho or parakeratotic cornification. No cell types. No inflammatory cells in the lamina propria.

Avoidance of chronic, artifactual, mechanical irritation. The patient must be informed about the mechanism of the skin changes, in severe cases psychotherapeutic assistance is recommended.

If the diagnosis is unclear, biopsy and histological control are indicated (to exclude precancerous leukoplakia).

1. Cam K et al (2012) Oral frictional hyperkeratosis (morsicatio buccarum): an entity to be considered in the differential diagnosis of white oral mucosal lesions. Skinmed 10:114-115
2. Glass LF et al (1991) Morsicatio buccarum et labiorum (excessive cheek and lip biting). At J Dermatopathol 13: 271-274
3. Silva DR et al (2003) Self-injurious behavior as a challenge for the dental practice: a case report. Pediatrist Dent 25: 62-66
4. Siragusa M et al (2013) Self-inflicted lesions of the mouth and lips in mentally retarded young subjects. Eur J Dermatol 23: 843-848