Mar, 2019 speckled leukoplakia consists of white flecks or fine nodules on an atrophic erythematous base. Leukoplakia is different from other causes of white patches such as thrush or lichen planus because it can eventually develop into oral cancer. The term oral erythroplakia is used to describe a red plaque or macular lesion in the mouth for which a specific clinical diagnosis cannot be established. However, treatment is a challenge and results are often mixed. Early detection and treatment of speckled leukoplakia. It is generally characterized by firm, white, leathery plaques.
Once you stop treatment, the white patches of hairy leukoplakia may return. Leukoplakia pictures, causes, symptoms, treatment and. Nonhomogeneous leukoplakia, or socalled speckled leukoplakia or nodular leukoplakia a predominantly white or white and red lesion erythroleukoplakia with an irregular texture that may be flat, nodular, exophytic, or papillaryverrucous is more likely to be potentially malignant. Leukoplakia patches can also develop on the female genital area. Once youve had leukoplakia, recurrences are common. Treatment for leukoplakia normally involves removing the source of irritation. The main goal of the treatment is the normalization of the vulvoscopic picture.
Although the white color in leukoplakia is a result of hyperkeratosis or acanthosis, similarly appearing white lesions that are caused by reactive keratosis smokers keratosis or frictional keratoses e. Speckled leukoplakia definition of speckled leukoplakia. Leukoplakia vulva is a chronic pathological process in the tissues of the vulva, characterized by inadequate proliferation of multilayer epithelium. When this isnt effective or if the lesions show early signs of cancer, the treatment plan may involve. Oral leukoplakia symptoms, diagnosis and treatment bmj. Biopsy must be considered in most cases of idiopathic leukoplakia to establish a microscopic baseline for the lesion.
Leukoplakia is a condition in which one or more white patches or spots lesions forms inside the mouth. Leukoplakia consisting of fine nodules or flecks which are white in color, with a base of atrophic erythematous nature verrucous or speckled leukoplakia, presence of ulcerations in the lesion, leukoplakia that is located beneath the surface of the tongue and anterior floor of the mouth. It often affects people with a weakened immune system, particularly those with hiv and aids or who have had an organ transplant and are taking immunosuppressant medication it causes fuzzy white patches, often on the sides of the tongue, that look folded or ridged. Conditions that may predispose to malignancy ie oral cancer include. Cleveland clinic is a nonprofit academic medical center. Speckled leukoplakia, where white patches are speckled with redder areas, may be particularly prone to being precancerous. Oral leukoplakia treatment with ent specialist dr meenesh.
The lesions may be any size and usually take weeks or months to form. Tretinoin retinoic acid and podophyllum resin solution are the standard topical medicines used for curing leukoplakia patches. Leukoplakia causes, pictures, symptoms, treatment, prognosis. May 10, 2019 leukoplakia is a condition in which thick, white or grayish patches form usually inside your mouth. It is also called chronic hyperplastic candidiasis and is caused by the candida species. Most leukoplakia patches are noncancerous benign, though some show early signs of cancer. Approximately 3 % of worldwide population has suffered. The patches normally begin as flat, grey sores before turning white and developing a rough, hardened texture. Sep 30, 2019 leukoplakia describes white patches on the roof of the mouth, tongue, and gums.
The sores can vary in appearance but are typically white or gray, and have thick, raised edges with a hard surface. Studies by banoczy and csiba, 4 pindborg et al 5 kramer et. Speckled leukoplakia definition of speckled leukoplakia by. Erythroplakia is a red area in the mouth that bleeds easily. While most patches of leukoplakia are not cancerous they are benign, some have early signs of cancer. These lesions can be regarded as a combination of or a transition between leukoplakia and erythroplasia, which is flat or depressed below the level of the surrounding mucosal red patch, is uncommon in the mouth, and carries the highest risk of. Characterized by white patch surface may be smooth or wrinkled.
When white leukoplakia patches mix with red patches, its called speckled leukoplakia, a possible indicator of cancer. Symptoms there are a number of symptoms that may accompany white spots on. Some cancers of the lower part of the mouth may occur near the foci of leukoplakia. Leukoplakia, also called leukokeratosis or leukoplasia is a medical condition in which plaque, keratin and irregular patch formation occurs on the mucous membrane of the oral cavity, gastrointestinal tract or the linings of the urinary tract and the genitals. And white areas mixed in with red areas speckled leukoplakia may indicate the potential for cancer. Leukoplakia is a condition in which thick, white patches or lesions appear within the mouth typically on the gums or inside the cheeks and is caused by excess cell growth. A white flecked or finely nodular lesion over an atrophic erythematous base that may be seen in a background of erythroplasia which is flat or depressed below the surrounding mucosa.
The growth can occur at any time in your life, but it is most common in the elderly. Though it is the common precancerous lesion, it poses a major diagnostic and. While most cases are benign and not linked to cancer, a variation with raised red lesions called speckled leukoplakia or erythroplakia may be associated with. If the leukoplakia patch was very small and it was completely removed by the excisional biopsy, no further treatment may be needed other than ongoing observation. Erythroplakia and speckled leukoplakia are oral precancerous lesions that have a high potential for malignant transformation.
They may be irregular in size or flat textured and hard in random areas. But they can also be precancerous and contain abnormal cells. Your doctor may recommend regular followup visits to monitor changes to your mouth or ongoing therapy to prevent leukoplakia patches from returning. Leukoplakia describes white patches on the roof of the mouth, tongue, and gums.
The treatment may eliminate the lesions, but they may return, or there may be other negative outcomes. To cure leukoplakia of the vulva is completely possible extremely rarely, since the true causes and mechanisms of its development are still unknown. Pdf early detection and treatment of speckled leukoplakia. Usually, you dont need treatment for hairy leukoplakia. Jun 21, 2018 leukoplakia sometimes may be misdiagnosed with oral thrush, which is a yeast infection which also causes white patches with the only difference being that the patches from oral thrush are much softer than the patches from leukoplakia. The lesion is commonly seen on the cheeks, lips, palate, and tongue. Sometimes, leukoplakia lesions develop on external female genitals.
We know it can be triggered by taking certain medications, including thiazide diuretics, antimalarials and phenothiazines a group of tranquilizing drugs with antipsychotic actions. Banoczy 5 showed that 26 percent of carcinomas developed in speckled leukoplakia, whilst only 2 percent carcinomas developed from theothertype ofleukoplakia. Therefore, it is advised to see the dentist if an individual has persistent, unusual changes in the mouth. Learn more from webmd about how leukoplakia is treated. Topical application of these drugs can bring about an improvement in the appearance of the patches. Most leukoplakia patches are benign or noncancerous, though few show early signs of cancer. In fact, it is the most commonly prevalent potentially malignant lesion of the oral region. If leukoplakia is caused by tobacco items, you will be asked to minimize or stop smoking completely, or utilizing other smokeless tobacco products. This finding is uncommon in the mouth, and carries a. Nov 06, 2019 while most patches of leukoplakia are not cancerous they are benign, some have early signs of cancer.
Leukoplakia, or white and gray patches inside the mouth, may be caused by irritation. Oral leukoplakia is the medical term for white patches formed in the oral cavity. This function is accomplished through a ligation between betacarotene and oxygen, which is an unstable reactive molecule, thus diminishing the damaging effects of free radicals lycopene in vitro experiments have shown the inhibition of the process of human neoplastic. It is appropriate to wait two weeks after the first presentation to assess clinical response to initial treatment, e. Cancers at the bottom of the mouth can occur next to areas of leukoplakia and white areas mixed in with red areas speckled leukoplakia may indicate the potential for cancer.
The diagnosis of leukoplakia hence starts with an oral examination to determine whether the patches are oral. Verrucous leukoplakia has an elevated, proliferative or corrugated surface appearance figure figure3. This finding is uncommon in the mouth, and carries a risk of malignant transformation. It is wellknown that epithelial dysplasia is a common feature of speckled leukoplakia. A retrospective analysis was conducted to investigate the clinicopathologic features of cases of oral erythroplakia and speckled leukoplakia in patients who were seen at a center specialized in stomatology and. Patches may be removed using a scalpel, a laser or an extremely cold probe that freezes and destroys cancer cells cryoprobe. Hairy leukoplakia usually does not require treatment. Leukoplakia is an oral condition that consists of white or grayish patches that cannot be removed or wiped away. But other irritants can cause this condition as well. Biopsy must be considered in most cases of idiopathic leukoplakia to establish a. Speckled leukoplakia is a rare type of leukoplakia with a very high risk of premalignant growth. Speckled leukoplakia sl according to who, is a leukoplakia with. Eastman dental institute oral medicine clinic journal of dental education 2002. Affected area of mucous membrane appears as a thickened greywhite plaque with cracks or fissures.
The main goal of treating leukoplakia is to prevent it from becoming cancer. Cancers on the bottom of the mouth can occur next to areas of leukoplakia. The essence of pathological changes in the vulvar mucosa is the appearance of delineated sections of the epithelium with uncharacteristic for this localization phenomena of keratinization. And white spotlights mixed with red spots speckled leukoplakia may indicate the potential for cancer to appear. Hairy leukoplakia of the mouth is an unusual form of leukoplakia that is seen only in people who are infected with hiv, have aids, or aidsrelated complex. Nobody knows what the exact causes of lichen planus are.
Leukoplakia management and treatment cleveland clinic. For most people, suppressing the cause of irritation, such as quitting smoking or drinking alcohol, eliminates the disorder. Regular checks are important, as is a routine inspection of the mouth for areas that do not look normal. If the patches do not clear up without treatment, a person. Leukoplakia sometimes may be misdiagnosed with oral thrush, which is a yeast infection which also causes white patches with the only difference being that the patches from oral thrush are much softer than the patches from leukoplakia. It causes fuzzy white patches, often on the sides of the tongue, that look folded or ridged. The speckled type is a white and red lesion, with a predominantly white surface figures figures2a 2a and and2b. Doctors give trusted, helpful answers on causes, diagnosis, symptoms, treatment, and more.
The nodular type has small polypoid outgrowths, rounded predominantly white excrescences figure figure5 5. Speckled leukoplakia is a rare type of leukoplakia with a very high risk of premalignant growth and mortality rate. Otherwise, the leukoplakia of the vulva is correlated with the precancerous process. Epithelial dysplasia commonly occurs 45 times more frequently in cl when compared with other forms of leukoplakia.
Treatment regular followup visits to the health care provider are vital, as is learning to thoroughly and regularly perform selfinspections of the mouth. Some erythroplakias are associated with white patches & hence termed, speckled leukoplakias any causal factor, such as tobacco, should be stopped lesions removed followed by regular followups leukoplakia aka white patch. Biopsy of clinically suspected oral leukoplakia is mandatory to. The diagnosis of leukoplakia hence starts with an oral examination to determine whether the patches are oral thrush or. Most patches of leukoplakia are benign, but a small number can show early cancer symptoms, and numerous mouth cancers develop beside the areas of leukoplakia. This function is accomplished through a ligation between betacarotene and oxygen, which is an unstable reactive molecule, thus diminishing the damaging effects of free radicals lycopene in vitro experiments have shown the inhibition of the process of human neoplastic cellular growth by lycopene, since this. The presence of white or gray colored patches on your tongue, gums, roof of your mouth, or the inside of the cheeks of your mouth may be a sign of leukoplakia. Leukoplakia could be classified as mucosal disease, and also as a premalignant condition. Youre likely to start by seeing your dentist or primary care professional. Hairy leukoplakia is a type of leukoplakia caused by the epsteinbarr virus.
Oral cavity is not the only region where leukoplakia can develop. A retrospective analysis was conducted to investigate the clinicopathologic features of cases of oral erythroplakia and speckled leukoplakia in patients who were seen at a center specialized in stomatology and histopathological diagnosis of oral diseases. It often affects people with a weakened immune system, particularly those with hiv and aids or who have had an organ transplant and are taking immunosuppressant medication. Leukoplakia is typically not hazardous, but it often can be serious. Leukoplakia is a condition in which thick, white or grayish patches form usually inside your mouth. Speckled leukoplakia, a clinical term to describe a patch that is both white and red, is generally regarded as a more ominous lesion because the red zones are less differentiated.