An Atlas of Lumps and Bumps: Part 14

AFFILIATIONS:

¹Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
²Alberta Children’s Hospital, Calgary, Alberta, Canada
³Toronto Dermatology Centre, Toronto, Ontario, Canada
⁴Department of Pediatrics and Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada
⁵Pediatric Institute, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia

CITATION:
Leung AKC, Barankin B, Lam JM, Leong KF. An atlas of lumps and bumps, part 14. Consultant. 2022;62(3):e36-e37. doi:10.25270/con.2022.02.00009

DISCLOSURES:
Dr Leung is the series editor. He was not involved with the handling of this paper, which was sent out for independent external peer review.

CORRESPONDENCE:
Alexander K. C. Leung, MD, #200, 233 16th Ave NW, Calgary, AB T2M 0H5, Canada (aleung@ucalgary.ca)

EDITOR’S NOTE:
This article is part of a series describing and differentiating dermatologic lumps and bumps. To access previously published articles in the series, visit https://www.consultant360.com/resource-center/atlas-lumps-and-bumps.

Parulis

Parulis, also known as gum boil, typically presents as an asymptomatic, yellowish or reddish papule or nodule on the gum at the oral end of a draining sinus (Figures 1 and 2). The lesion is usually secondary to a chronic periapical or alveolar abscess, which may result from untreated dental caries.¹ The maxillary alveolar mucosa is the most frequent site of a parulis. Causative organisms include Fusobacterium species, followed by Prevotella intermedia/nigrescens, Porphyromonas gingivalis, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans.^2,3 A parulis usually perforates spontaneously with purulent discharge into the oral cavity.⁴ Occasionally, parulides may be complicated by periodontal fistula formation.

Traumatic Fibroma of the Tongue

A traumatic fibroma, also known as irritation fibroma, of the tongue is a benign, exophytic and reactive oral lesion.^5,6 The prevalence rate ranges from 1.2 to 77 per 1000 individuals aged 15 to 82 years with a peak in the fourth decade of life.⁵ The sex ratio is approximately equal.⁵ The condition results from repetitive tissue injury, which leads to fibrous hyperplasia. The lesion can be tender when rough food comes into contact; this may also occasionally cause the fibroma to bleed.

Clinically, a traumatic fibroma of the tongue presents as a sessile, well-circumscribed, firm lesion that is most often located on the lateral aspect of the tongue (Figure 3), followed by the tip of the tongue (Figures 4 and 5). There is no risk of malignant transformation.⁵