Leukoplakia
Encyclopedia
Leukoplakia is a clinical term used to describe patches of keratosis
. It is visible as adherent white patches on the mucous membranes of the oral cavity, including the tongue
, but also other areas of the gastro-intestinal tract, urinary tract and the genitals. The clinical appearance is highly variable. Leukoplakia is not a specific disease entity, but is diagnosis of exclusion
. It must be distinguished from diseases that may cause similar white lesions, such as candidiasis
or lichen planus
. The lesions of leukoplakia cannot be scraped off easily
It is sometimes described as precancerous. It is also associated with smoking.
Tobacco
, either smoked or chewed, is considered to be the main culprit in its development. (1998-2010 Mayo Foundation for Medical Education and Research (MFMER).
The term "candidal leukoplakia" is sometimes used to describe certain types of oral candidiasis
.
Although the term "leukoplakia" often applies to conditions of the mouth, it can also be used to describe conditions of the genitals and urinary tract.
, leukoplakia is usually found in adults between 40 and 70 years of age, with a 2:1 male predominance.
and possibly alcohol. Simultaneously serum levels of patients with leukoplakia were found to be low in Vit A,B-12,C & folic acid,in a study conducted in India. Most result from chronic irritation of mucous membranes by carcinogens. Bloodroot
, otherwise known as sanguinaria, is also believed to be associated with leukoplakia.
5% to 25% of leukoplakias are premalignant lesions; therefore, all leukoplakias should be treated as premalignant lesions by dentists and physicians - they require histologic evaluation or biopsy. Hairy leukoplakia
, which is associated with HIV
infection and other diseases of severe immune deficiency can go on to develop lymphoma when associated with HIV.
from alcohol
— and avoidance of chronic irritants, e.g., the sharp edges of teeth. A biopsy
should be done, and the lesion surgically excised if pre-cancerous changes or cancer is detected.
Taking beta-carotene
orally seems to induce remission in patients with oral leukoplakia. Further research is needed to confirm these results.
Keratosis
Keratosis is a growth of keratin on the skin. More specifically, it can refer to:* actinic keratosis * hydrocarbon keratosis* keratosis pilaris , also known as * seborrheic keratosis-See also:...
. It is visible as adherent white patches on the mucous membranes of the oral cavity, including the tongue
Tongue
The tongue is a muscular hydrostat on the floors of the mouths of most vertebrates which manipulates food for mastication. It is the primary organ of taste , as much of the upper surface of the tongue is covered in papillae and taste buds. It is sensitive and kept moist by saliva, and is richly...
, but also other areas of the gastro-intestinal tract, urinary tract and the genitals. The clinical appearance is highly variable. Leukoplakia is not a specific disease entity, but is diagnosis of exclusion
Diagnosis of exclusion
A diagnosis of exclusion is a medical condition reached by a process of elimination, which may be necessary if presence cannot be established with complete confidence from examination or testing...
. It must be distinguished from diseases that may cause similar white lesions, such as candidiasis
Candidiasis
Thrush redirects here. For the hoof infection see Thrush .Candidiasis or thrush is a fungal infection of any of the Candida species , of which Candida albicans is the most common...
or lichen planus
Lichen planus
Lichen planus is a chronic mucocutaneous disease that affects the skin, tongue, and oral mucosa. The disease presents itself in the form of papules, lesions, or rashes. Lichen planus does not involve lichens, the fungus/algae symbionts that often grow on tree trunks; the name refers to the dry and...
. The lesions of leukoplakia cannot be scraped off easily
It is sometimes described as precancerous. It is also associated with smoking.
Tobacco
Tobacco
Tobacco is an agricultural product processed from the leaves of plants in the genus Nicotiana. It can be consumed, used as a pesticide and, in the form of nicotine tartrate, used in some medicines...
, either smoked or chewed, is considered to be the main culprit in its development. (1998-2010 Mayo Foundation for Medical Education and Research (MFMER).
The term "candidal leukoplakia" is sometimes used to describe certain types of oral candidiasis
Candidiasis
Thrush redirects here. For the hoof infection see Thrush .Candidiasis or thrush is a fungal infection of any of the Candida species , of which Candida albicans is the most common...
.
Although the term "leukoplakia" often applies to conditions of the mouth, it can also be used to describe conditions of the genitals and urinary tract.
Incidence and prevalence
Leukoplakic lesions are found in approximately 3% of the world's population. Like erythroplakiaErythroplakia
Erythroplakia is a flat red patch or lesion in the mouth that cannot be attributed to any other pathology.A similar term is "erythroplasia", which has a papular appearance.- Diagnosis and associated conditions :...
, leukoplakia is usually found in adults between 40 and 70 years of age, with a 2:1 male predominance.
Causes
Leukoplakia is primarily caused by the use of tobacco. Other possible etiological agents implicated are HPV, Candida albicansCandida albicans
Candida albicans is a diploid fungus that grows both as yeast and filamentous cells and a causal agent of opportunistic oral and genital infections in humans. Systemic fungal infections including those by C...
and possibly alcohol. Simultaneously serum levels of patients with leukoplakia were found to be low in Vit A,B-12,C & folic acid,in a study conducted in India. Most result from chronic irritation of mucous membranes by carcinogens. Bloodroot
Bloodroot
Bloodroot is a perennial, herbaceous flowering plant native to eastern North America from Nova Scotia, Canada southward to Florida, United States...
, otherwise known as sanguinaria, is also believed to be associated with leukoplakia.
5% to 25% of leukoplakias are premalignant lesions; therefore, all leukoplakias should be treated as premalignant lesions by dentists and physicians - they require histologic evaluation or biopsy. Hairy leukoplakia
Hairy leukoplakia
Hairy leukoplakia is a white patch on the side of the tongue with a corrugated or hairy appearance.-Causes:...
, which is associated with HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
infection and other diseases of severe immune deficiency can go on to develop lymphoma when associated with HIV.
Treatment
The treatment of leukoplakia mainly involves avoidance of predisposing factors — tobacco cessation, abstinenceAbstinence
Abstinence is a voluntary restraint from indulging in bodily activities that are widely experienced as giving pleasure. Most frequently, the term refers to sexual abstinence, or abstention from alcohol or food. The practice can arise from religious prohibitions or practical...
from alcohol
Alcohol
In chemistry, an alcohol is an organic compound in which the hydroxy functional group is bound to a carbon atom. In particular, this carbon center should be saturated, having single bonds to three other atoms....
— and avoidance of chronic irritants, e.g., the sharp edges of teeth. A biopsy
Biopsy
A biopsy is a medical test involving sampling of cells or tissues for examination. It is the medical removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically...
should be done, and the lesion surgically excised if pre-cancerous changes or cancer is detected.
Taking beta-carotene
Beta-carotene
β-Carotene is a strongly-coloured red-orange pigment abundant in plants and fruits. It is an organic compound and chemically is classified as a hydrocarbon and specifically as a terpenoid , reflecting its derivation from isoprene units...
orally seems to induce remission in patients with oral leukoplakia. Further research is needed to confirm these results.
See also
- Leukoplakia with tylosis and esophageal carcinomaLeukoplakia with tylosis and esophageal carcinomaLeukoplakia with tylosis and esophageal carcinoma is a rare condition characterized by leukoplakia associated with esophageal carcinoma....
- Proliferative verrucous leukoplakiaProliferative verrucous leukoplakiaProliferative verrucous leukoplakia is a slowly progressive condition characterized by thickened and enlarged sites of oral mucous membrane.- See also :* Acquired dyskeratotic leukoplakia* Oral florid papillomatosis* Mucous membrane...
- List of cutaneous conditions