The atrophic epithelium in OSF has been attributed to the senescence of basal stem cell layer and the development of hyperplastic epithelium through senescence escape. Diagnosis
Classification
Oral submucous fibrosis is clinically divided into three stages:
Stage 1: Stomatitis
Stage 2: Fibrosis
a- Early lesions, blanching of the oral mucosa
b- Older lesions, vertical and circular palpable fibrous bands in and around the mouth or lips, resulting in a mottled, marble-like appearance of the buccal mucosa
Stage 3: Sequelae of oral submucous fibrosis
a- Leukoplakia
b- Speech and hearing deficitsKhanna and Andrade in 1995 developed a group classification system for the surgical management of trismus:
Group I:  Earliest stage without mouth opening limitations with an interincisal distance of greater than 35 mm. Group II:  Patients with an interincisal distance of 26–35 mm. Group III:  Moderately advanced cases with an interincisal distance of 15–26 mm. Fibrotic bands are visible at the soft palate, and pterygomandibular raphe and anterior pillars of fauces are present. Group IVA:  Trismus is severe, with an interincisal distance of less than 15 mm and extensive fibrosis of all the oral mucosa. Group IVB:  Disease is most advanced, with premalignant and malignant changes throughout the mucosa.tumor necrosis factor alpha and keratin 17 areinterdependent regulators, they could be used as diagnostic makers and a prognostic mirror of oral
submucous fibrosis cases

Treatment
Biopsy screening although necessary is not mandatory most dentist can visually examine the area and proceed with the proper course of treatment.
A variant of eccrine spiradenoma which can be multiple on the scalp and can  coalesce to form a Turban tumour. In pathology, a cylindroma is a tumour with nests of cells that resemble a cylinder in cross section. Types include:

Dermal eccrine cylindroma, a benign tumour of the skin
Adenoid cystic carcinoma, a malignant tumour of the salivary gland

See also
CYLD cutaneous syndrome
List of cutaneous neoplasms associated with systemic syndromes


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