Leukoplakia
Overview
Leukoplakia is adherent white plaques or patches on the mucous membranes of the oral cavity, including the tongue. 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.
Symptoms
The primary symptom of leukoplakia is a skin lesion with the following characteristics: * Location o Usually on the tongue o May be on the inside of the cheeks o In females, occasionally on the genitals * Color o Usually white or gray o May be red (called erythroplakia) * Texture o Thick o Slightly raised o Hardened surface The symptoms of hairy leukoplakia are painless, fuzzy, white patches on the tongue.
Causes
Leukoplakia has a multifactorial etiology. Most result from the use of tobacco products. It is thought to be formed by chronic irritation in the mouth. Bloodroot, otherwise known as sanguinaria, is also believed to be associated with leukoplakia.[1] 5% to 25% of leukoplakias are premalignant lesions; wherefore, 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, is not a premalignant lesion.
Prevention
Minimize or stop smoking or other tobacco use. Have rough teeth treated and dental appliances repaired promptly. Safer sexual practices minimize the risk of contracting sexually-transmitted diseases, including HIV.
Treatment
The treatment of leukoplakia mainly involves avoidance of predisposing factors — tobacco cessation, smoking, quitting betel chewing, abstinence 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