Two further cases of leukoplakia progressing to squamous cell carcinoma are reported. With leukoplakia lookohplaykeyuh, thickened, white patches form on your gums, the insides of your cheeks. Leukoplakia, precancerous tumour of the mucous membranes, usually seen in the mouth or on the tongue or cheeks, but also known to occur on the lips, as well as on the vagina, vulva, or anus. Treatment, if needed, involves removing the source of irritation. Leukoplakia genetic and rare diseases information center. Leukoplakia management and treatment cleveland clinic. The sores can vary in appearance but are typically white or gray, and have thick, raised edges with a hard surface. The aim of this paper was to assess the nonsurgical treatment of oral leukoplakia ol. It the reason behind the condition is smoking, then the patient would have to cut down or entirely eliminate his or her smoking habit. The main goal of treating leukoplakia is to prevent it from becoming cancer. Leukoplakia, management, surgical, nonsurgical treatment, download full text pdf 512 kb please cite this article in pubmed style or ama american medical association style. Biopsy of clinically suspected oral leukoplakia is mandatory to. Usually, removing the source of the irritation smoking, chewing tobacco, or excessive alcohol use will be enough to cure. Hairy leukoplakia is a condition that is characterised by irregular white patches on the side of the tongue and occasionally elsewhere on the tongue or in the mouth.
Leukoplakia is almost always benign in nature with a very small chance of it progressing to cancer. Leukoplakia is a predominantly white lesion of the oral mucosa that carries an increased risk of malignant. Leukoplakia is a white or gray patch that develops on the tongue, the inside of the cheek, or on the floor of the mouth. But other irritants can cause this condition as well. Tretinoin retinoic acid and podophyllum resin solution are the standard topical medicines used for curing leukoplakia patches. Site % of leukoplakia at this site % of leukoplakia at this site that show dysplasia or carcinoma mandibular mucosa and sulcus 25. The treatment may eliminate the lesions, but they may return, or there may be other negative outcomes.
Leukoplakia is a precancerous mucous membrane condition manifested by white patches that develops on the tongue, gums, or the inside of the cheek. Therefore, it is advised to see the dentist if an individual has persistent, unusual changes in the mouth. Leukoplakia pictures, causes, symptoms, treatment and. Although the sores can vary in appearance, they are usually white or gray. Oral hairy leukoplakia is a condition triggered by the epsteinbarr virus ebv. Leukoplakia of the tongue cleveland clinic journal of medicine. Pdf oral leukoplakia is the most common potentially malignant disorder affecting oral cavity. Leukoplakia first appears as a small, smooth, white spot that cannot be scraped off but develops into a larger area of thickening with a rough texture and colour varying from white to gray. Treatment of leukoplakia would involve the removal of the source of irritation.
The list of treatments mentioned in various sources for leukoplakia includes the following list. Linking all these considerations we hereby aim to propose guidelinesfor appropriate management of oral leukoplakia in indian scenario. A type of leukoplakia of the mouth, called oral hairy leukoplakia, is caused by the epsteinbarr virus. Leukoplakia is a condition that involves white patches or spots on the inside of the mouth. Oral leukoplakia ol is a white patch or plaque that cannot be rubbed off, cannot be characterized clinically or histologically as any other condition, and is not associated with any physical or chemical causative agent except tobacco. Oral leukoplakia is a potentially malignant disorder affecting the oral mucosa. It has been defined as a predominantly white lesion of the oral mucosa that cannot be characterized as any other definable lesion. Management and treatment of leukoplakia remain challenging especially for large lesions and the proliferative subtype. Proliferative verrucous leukoplakia genetic and rare. However, treatment is a challenge and results are often mixed. These patches are typically painless and usually noncancerous benign. Regular followup visits to the health care provider are vital, as is learning to thoroughly and regularly perform selfinspections of the mouth. Proliferative verrucous leukoplakia is a rare form of ol which has multiple recurrences, is refractory to treatment and has malignant transformation in a short period.
It can also be a sign of precancerous changes in the mouth or mouth cancer. This pathology is associated with epsteinbarr virus ebv and occurs mostly in people with hiv, both immunocompromised and immunocompetent, albeit it can affect patients who are hiv negative. Jun 21, 2018 in majority of the cases, leukoplakia goes away on its own and does not require any treatment, but it is important to identify the cause of leukoplakia and staying away from it. Oral leukoplakia remains a challenging condition villa. According to the world health organization, the term leukoplakia should be reserved for white plaques of questionable risk, having excluded other known diseases or disorders that carry no increased risk for cancer.
If leukoplakia is caused by smoking, you will be asked to minimize or stop smoking or using other tobacco products. Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126 tollfree. Methods we examined 38 lesions in 35 patients of lingual leukoplakia who underwent co2 laser treatment with using lugol staining at our department over a 10year period, i. Hairy leukoplakia is a result of infections stemming from the epsteinbarr virus ebv, which remains in the body for your lifetime. It has a number of possible causes, including repeated injury or irritation. Leukoplakia is a condition wherein white or gray patches appear in some parts of the mouth, predominantly in the buccal mucosa and the tongue.
For example, if leukoplakia is caused by a rough tooth or an irregular surface on a denture or filling the tooth will be smoothed and dental appliances repaired. 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. Usually, you dont need treatment for hairy leukoplakia. Hairy leukoplakia creates fuzzy, white patches that can be mistaken for oral thrush. Leukoplakia is a condition in which thick, white or grayish patches form usually inside your mouth. Treatment of oral hairy leukoplakia with podophyllin jama. It is defined as essentially an oral mucosal white lesion that cannot be considered. Leukoplakia treatment considerations and causes colgate. Common vitamins and supplements to treat oral leukoplakia. It is the mouths reaction to chronic irritation of the mucous membranes of.
Studies showed a rate higher than 50% of clinical resolution with photodynamic therapy, betacarotene, lycopene, or vitamin a. Topical application of these drugs can bring about an improvement in the appearance of the patches. Sep 11, 2017 lee akst, director laryngology, john hopkins voice center, discusses leukoplakia treatment. Oral hairy leukoplakia can also appear in other people whose immune system is not working well, such as after a bone marrow transplant. 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.
Details of clinical and pathological findings and of treatment are given. Once youve had leukoplakia, recurrences are common. Shortly after that, the definition was modified as a predominantly white lesion of the oral. The condition is thought to be caused by irritation, but the cause is not always known.
Cleveland clinic is a nonprofit academic medical center. Leukoplakia, management, surgical, nonsurgical treatment, introduction oral leukoplakia ol is the most frequent precancerous lesion of the oral cavity. Treatment consists of surgery with or without additional radiotherapy and chemotherapy. Leukoplakia causes, pictures, symptoms, treatment, prognosis. In the eye, leukoplakia is thought usually to arise from the limbal conjunctiva in the temporal region. Proliferative verrucous leukoplakia pvl is a rare type of oral leukoplakia, where white patches that have a high risk of becoming cancerous develop inside the mouth. It is good to hear hat you have quit using the smokeless tobacco. Leukoplakia could be classified as mucosal disease, and also as a premalignant condition. One study found that men over the age of 60 with oral leukoplakia on the lateral or ventral aspect of the tongue, who had a nonhomogenous lesion with highgrade dysplasia, were most at risk of malignant change 8. Treatment of leukoplakia is most effective after early diagnosis. Leukoplakiaa diagnostic and management algorithm sciencedirect. Oral leukoplakia ol is the most typical potentially malignant disorder of the oral mucosa. It is a form of leukoplakia, which refers to white patches on the mucous membranes of the mouth often arising in response to chronic irritation.
For most people, removing the source of irritation. Nov 10, 2016 leukoplakia of the anterior floor of the mouth and undersurface of the tongue is strongly associated with malignant potential. May 21, 2012 leukoplakia is a condition in which thickened, white patches form on the tongue, gums, inside of the cheek, or sometimes on the outer female genitals. For language access assistance, contact the ncats public information officer. Treatment with acyclovir, desciclovir, ganciclovir, zidovudine, and topical tretinoin have been reported to help regression of the leukoplakia but, even when effective, the lesions usually recur following discontinuation of therapy. The management of oral leukoplakia varies from a wait and see attitude and topical chemopreventive agents to complete surgical removal. However, it is important to provide careful and appropriate care to avoid future, avoidable problems.
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. Leukoplakia appears as thick, white patches on the inside surfaces of your mouth. Always seek professional medical advice about any treatment or. Leukoplakia is a firmly attached white patch on a mucous membrane which is associated with an increased risk of cancer. Treatment for leukoplakia involves removing the source of irritation. If leukoplakia has been caused by tobacco use then abstaining from tobacco use is the best way to treat leukoplakia and prevent future recurrences of it. May 10, 2019 leukoplakia is a condition in which thick, white or grayish patches form usually inside your mouth.
It can be caused by chewing tobacco, heavy smoking, and alcohol use. It starts as a white plaque of thickened skin hyperkeratosis that eventually spreads and forms rough, wartlike verrucous lesions that may look. Leukoplakia treatment is most successful when a lesion is found and treated early, when its small. Jan 29, 20 proliferative verrucous leukoplakia is a rare form of ol which has multiple recurrences, is refractory to treatment and has malignant transformation in a short period. Leukoplakia is typically not hazardous, but it often can be serious. Histopathology of leukoplakia can disclose hyperkeratosis with dysplasia or carcinoma or hyperkeratosis or parakeratosis without dysplasia. Oral leukoplakia ol is a white patch or plaque of the oral mucosa that cannot be characterised clinically or pathologically as any other condition such as cheek biting, candidosis, lichen planus and materia alba.
The diagnosis of leukoplakia hence starts with an oral examination to determine whether the patches are oral thrush or indeed leukoplakia. The course of the disease almost does not cause discomfort and in a stable form can accompany human life. It mainly involves the lining inside of the cheeks buccal mucosa and tongue. Download fulltext pdf download fulltext pdf download fulltext pdf. You can also get them on the inside of your cheeks. Pdf the aim of this paper was to assess the nonsurgical treatment of. Treatment of oral hairy leukoplakia with podophyllin. Oral leukoplakia is a condition that causes white patches to form inside the mouth. Leukoplakia is different from other causes of white patches such as thrush or. It develops in the mouth, genital, and in some cases, it is formed in the internal organs. Leukoplakia is a precancerous lesion usually associated with the mucous membranes of the mouth or genitalia. However, leukoplakia is not limited as an oral disorder alone, as it may also appear in the genital area of the female.
A series of 20 cases of leukoplakia of the bladder is reported. The appearance of keratinized areas of multilayered epithelium on the mucous membranes suggests leukokeratosis. It is appropriate to wait two weeks after the first presentation to assess clinical response to initial treatment, e. It usually occurs within the mouth, although sometimes mucosa in other parts of the gastrointestinal tract, urinary.
A white patch in your mouth that does not go away should be checked by a dentist or gp. 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. Occasionally, patches develop on the female external genitalia. Sometimes the patches happen in other parts of your mouth. Proliferative verrucous leukoplakia is a diffuse white andor papillary lesion seen in older patients, often associated with human papilloma viruses, which has an inexorably slow progression over one or two decades, to verrucous or squamous cell carcinoma candidal leukoplakias may be associated with an increased risk of malignant change ch. An overview of oral leukoplakia cosmo dental centre. Hairy leukoplakia is a type of leukoplakia caused by the epsteinbarr virus. Hairy leukoplakia usually does not require treatment. Leukoplakia buccalis, leukokeratosis or smokers patch is one of the most common lesions that one encounters in an examination of the oral cavity. The main purpose of oral leukoplakia management is to avoid malignant transformation of the lesion or if this happened to detect this in early stages. Type of surgical treatment and recurrence of oral leukoplakia. Leukoplakia treatment considerations and causes by emily boge, rdh, bs, mpac leukoplakia is a broad term that defines lesions that appear as white patches found in the inner lining of the mouth, and leukoplakia treatment varies because the condition has a myriad causes. Mar, 2019 oral leukoplakia ol is a white patch or plaque that cannot be rubbed off, cannot be characterized clinically or histologically as any other condition, and is not associated with any physical or chemical causative agent except tobacco. 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.
As it is said, prevention is always better than cure. Conservative treatment includes use of chemopreventive agents such as vitamins vitamins a, c, e. Regular checkups are important, as is routinely inspecting your mouth for areas that dont look normal. There is another form called hairy leukoplakia that, like oral thrush, affects those with weakened immune systems more adversely. Leukoplakia is a common condition characterized by an increased risk for malignant transformation. Nov 15, 2011 hairy leukoplakia usually does not require treatment. The medical management of leukoplakia usually involves. The edges of the lesion are typically abrupt and the lesion changes with time. Leukoplakia first appears as a small, smooth, white spot that cannot be scraped off but develops into a. Oral leukoplakia ol is the most common premalignant lesion of oral mucosa and it was first described by the world health organization in 1978 as a white patch or plaque that cannot be. Aug 05, 2019 oral hairy leukoplakia ohl is a disease of the mucosa first described in 1984. These white patches form along the gums, inside the cheeks, the bottom of the mouth, andor on the tongue.
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. Leukoplakia is a condition in which one or more white patches or spots lesions forms inside the mouth. Various surgical and nonsurgical treatments have been reported, but currently there is no universal consensus on the most appropriate one and on the duration or interval of followup of patients with this condition. The problem of the treatment of this condition is discussed. Leukoplakia is a condition in which thickened, white patches form on the tongue, gums, inside of the cheek, or sometimes on the outer female genitals. If you have problems viewing pdf files, download the latest version of adobe reader. Treatment depends on demographic, social, clinical, and histopathologic factors. If the cause is a rough tooth or an illfitting denture, then these would be corrected by the dentist. These treatments may be effective for resolution of the lesions. The primary outcomes of interest were clinical resolution, malignant transformation, followup, and recurrence of ol. Histopathology of leukoplakia can disclose hyperkeratosis with dysplasia or carcinoma or. 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. Ol is premalignant and is associated with squamous cell carcinoma scc.
Pdf nonsurgical management of oral leukoplakia researchgate. Dysplasia, oral leukoplakia, treatment introduction oral leukoplakia is defined as a predominantly white lesion of the oral mucosa that cannot be characterized as any other definable lesion. Oral hairy leukoplakia happens most often in people with weak immune systems. In an international symposium in sweden, in 1994, leukoplakia was defined as a predominantly white lesion of the oral mucosa that cannot be characterized as any other definable disease, some oral leukoplakias will transform into cancer. The most effective methods of oral leukoplakia treatment. Patches may be removed using a scalpel, a laser or an extremely cold probe that freezes and destroys cancer cells cryoprobe. Oral leukoplakia is an oral potentially malignant disorder opmd that presents as white patches of the oral mucosa.