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Aims To immunohistochemically evaluate the cytokeratin ( CK) pattern of expression in localized juvenile spongiotic gingival hyperplasia ( LJSGH) as compared with the gingival epithelium ( GE). Methods and results Ten cases of LJSGH were semiquantitatively evaluated for the immunohistochemical pattern of CK1/10, CK4, CK8/18, and CK19. GE controls were taken from 10 cases of reactive gingival fibroepithelial hyperplasia. GEs showed mean positivity rates of 80% for both CK1/10 and CK4, and 5% for both CK8/18 and CK19. LJSGHs showed mean positivity rates of 65% for CK19, 60% for CK8/18, 30% for CK4, and 5% for CK1/10. The differences between LJSGHs and GEs were statistically significant ( P < 0.01). Conclusions The LJSGH pattern of CK expression is reminiscent of the profile described in the literature for the junctional epithelium ( JE). Possibly, JE exteriorized from the gingival sulcus would be more prone to irritation from a variety of sources, resulting in inflammation and hyperplasia, with the subsequent development of LJSGH. [ABSTRACT FROM AUTHOR]