Letter to the Editor: Human papilloma virus (HPV) associated oral epithelial dysplasia: Emerging evidence, diagnostic challenges, and future directions.

The recent article on Human Papillomavirus-associated Oral Epithelial Dysplasia (HPV-OED) provides critical insights into this emerging pathological entity, now recognized by the World Health Organization as a distinct subtype of oral epithelial dysplasia. The authors present one of the largest single-institution cohorts of HPV-OED, offering robust clinico-pathological characterization through p16 immunohistochemistry and HPV-specific molecular diagnostics. Their findings emphasize the importance of standardized diagnostic criteria to distinguish HPV-OED from conventional OED. A notable observation is the association between HIV-positive status and increased risk of malignant transformation, underscoring the need for heightened surveillance in immunocompromised populations. This study contributes significantly to the understanding of HPV-OED's natural history and supports broader implementation of molecular HPV testing in high-risk dysplastic oral lesions. Future studies could enhance clinical relevance through inclusion of matched conventional OED controls, HPV genotyping with viral load assessment, and additional biomarkers (e.g., TP53, PD-L1, Ki-67). Moreover, longer-term follow-up, survival analyses, and advanced molecular techniques such as qPCR, RT-qPCR, and next-generation sequencing are recommended to improve diagnostic accuracy and patient management strategies.