A 47-year old Chinese woman presented with a 2-year history of multiple small flammulated papilloma-liked lesions on her tongue. She has noted an increase of the size and number of lesions within the past month, with significant harsh feeling, but the taste sensation is normal. The physical examination showed diffusely multiple, florid, and slight raised spots in different sizes, measuring from 1 to 3mm in dimensions, appearing on the dorsal surface and lateral borders of the tongue (Figure A and B). Incisional biopsy of the lesion area showed papillary mucosal epithelial, dermal superficial collagen bundle and mucous matrix hyperplasia (figure C). She denied any other cutaneous or systemic abnormalities. Based on histopathological examination, a diagnosis of squamous papilloma was made.

Squamous papillomais benign tumor, occurring anywhere of oral cavities of people ranging from 11 to 40 years old, which is clinically characterized by red or white verrucous, finger- or cauliflower-shaped lesions [1]. It is very rare disease and causative agent has not yet determined. The currently accepted pathogenesis includes human papilloma virus (HPV) infection, smoking, and chronic inflammatory. However, the tests for HPV evidence in this case were all negative in the samples of blood, saliva and lesions. She has never smoked the cigarette. Available therapeutic options for this tumor are photodynamic treatment, systemic retinoid, chemotherapy and surgical excision [2].