Human Papillomavirus (HPV) can affect various parts of the body, including the mouth and throat. While many HPV infections do not cause noticeable symptoms, some can lead to visible lesions. This article describes what oral HPV manifestations commonly look like and where they tend to appear.
Typical Oral HPV Manifestations
Oral HPV lesions often present as small growths or bumps within the mouth. These growths can vary in color, appearing flesh-colored, whitish, or occasionally pink or red, depending on the lesion’s keratinization. The texture of these lesions can also differ; some may be rough and have a cauliflower-like, lumpy, or cobblestone appearance, while others might be smoother and dome-shaped.
Oral growths are small, usually only a few millimeters, though their dimensions can vary. They may occur as solitary bumps or as multiple lesions that can sometimes cluster together. Many oral HPV lesions are painless and do not cause significant discomfort, making them easy to overlook.
These lesions are slow-growing. Common types of benign oral HPV-related lesions include squamous papillomas, verruca vulgaris (common warts), condyloma acuminatum, and multifocal epithelial hyperplasia. While some HPV strains can lead to oral cancers, the visible lesions themselves are not cancerous.
Where Oral HPV Lesions Appear
Oral HPV lesions can develop in various locations throughout the mouth and throat. They are frequently found on the tongue, particularly along its sides and underside. The soft palate, located at the back of the roof of the mouth, is another common site for these growths.
Lesions may also appear on the tonsils, lips, gums, and the inside of the cheeks. While these growths can occur anywhere on the oral mucosa, certain areas like the soft palate and tongue are more commonly affected. HPV-positive cancers, distinct from benign lesions, develop in areas like the back of the tongue and the tonsils, making them sometimes difficult to detect.
Distinguishing Oral HPV from Other Conditions
Differentiating oral HPV lesions from other common oral conditions can be challenging due to overlapping appearances. Frictional keratosis or fibromas, resulting from chronic irritation or trauma, appear as smooth, firm, and solitary bumps. Unlike HPV lesions, which can have a rough or cauliflower-like texture, fibromas have a uniform, non-warty surface.
Canker sores, known medically as aphthous ulcers, are painful, open sores with a distinct white or yellowish center surrounded by a red border. They are not caused by HPV and heal within one to two weeks, whereas HPV lesions are painless and persist longer. Cold sores, or herpes labialis, caused by the herpes simplex virus, manifest as fluid-filled blisters that eventually crust over, commonly on the lips, and are painful.
Mucoceles are fluid-filled sacs that form on the lower lip or the floor of the mouth due to blocked or ruptured salivary glands. They are soft, translucent, and smooth, differing from the solid, textured appearance of oral HPV growths. Given the diverse presentation of oral lesions, self-diagnosis is not reliable due to the many conditions that can mimic HPV.
Importance of Professional Diagnosis
Accurately identifying oral lesions, including those potentially caused by HPV, requires evaluation by a healthcare professional. A dentist, oral surgeon, or physician possesses the expertise to distinguish between various oral conditions and determine the underlying cause. Visual inspection alone is insufficient for a definitive diagnosis of oral HPV.
When a suspicious lesion is observed, a healthcare provider may recommend a biopsy, which involves taking a small tissue sample for laboratory analysis. This microscopic examination of the tissue confirms the nature of the lesion, including whether it is related to HPV or if it indicates a more serious condition. Consulting a medical professional is the appropriate step if any unusual or persistent changes are noticed in the mouth.