@Dr_MMagalhaes @HeadandNeckPath@ENTpathology Completely agree, note demarcation. I use Dermpath terminology - HK is hyperorthokeratosis and parakeratosis is just that, and always abnormal except on tongue dorsum which can have hyperparKeratosis.
@Dr_MMagalhaes @ErnestoDuarteMD The important word here (I agree with Lama) are the words “not reactive” to differentiate it from reactive keratosis. Clinically this is dysplastic.