High rate of recurrence and histological progression toward carcinoma. The main goal of treating leukoplakia is to prevent it from becoming cancer. Oral leukoplakia is a potentially malignant disorder affecting the oral mucosa. Leukoedema, a grayishwhite lesion of the oral mucosa in humans, was once thought to be a probable precursor to leukoplakia.
Pdf leukoplakia is the most common premalignant or potentially. Irritation from rough teeth, fillings, or crowns, or illfitting dentures that rub against your cheek or gum. Leukoplakia, or white and gray patches inside the mouth, may be caused by irritation. A voluminous literature has been written on the subject over many years, and yet several facts about the condition need to be elucidated. Leukoplakia and erythroplakia are the two most common potentially malignant disorders of the oral cavity. Most cases of oral leukoplakia occur in persons in the fifth to seventh decades of life. Oral leukoplakia list of high impact articles ppts. Information on oral diseases the american academy of. Sonia gupta 1, manveen kaur jawanda 2 1 department of oral pathology, swami devi dyal hospital and dental college, golpura, barwala, punjab, india 2 laxmibai institute of dental sciences and hospital, patiala, punjab, india. Oral leukoplakia is an oral potentially malignant disorder opmd that presents as white patches of the oral mucosa. Oral leukoplakia genetic and rare diseases information. But other irritants can cause this condition as well. Important research into oral and oropharyngeal cancers is taking place in many university hospitals, medical centers, and other institutions around the country.
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. 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. As a result of the who definition of oral leukoplakia, the. 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. May 21, 2012 although most leukoplakia patches are benign noncancerous, a small percentage show early signs of cancer, and many cancers of the mouth occur next to areas of leukoplakia.
Sometimes the patches happen in other parts of your mouth. Leukoplakia, management, surgical, nonsurgical treatment, introduction oral leukoplakia ol is the most frequent precancerous lesion of the oral cavity. Oral hairy leukoplakia is an opportunistic infection by epstein barr virus. Additionally, the use of areca betel nut preparations in many parts of the world generally south and southeast asia poses a significant risk, as does the use of dry. Much has been written about the malignant potential of oral leukoplakia, but too often the dental profession has ignored the more dangerous. 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. The most commonly associated risk factor is the use of tobacco in either smoked or smokeless form. Leukoplakia buccalis, leukokeratosis or smokers patch is one of the most common lesions that one encounters in an examination of the oral cavity.
The presence of leukoplakia in adolescent users of. Though it may occur in any part of the mouth, it generally affects the tongue, gums, and inner cheek. Oral leukoplakia ol is the most frequent potentially malignant disorder of oral mucosa. Leukoplakia basically occurs due to an uncharacteristic epithelial differentiation usually brought about by longterm, constant irritation to the oral mucosa. It seems preferable to use the term leukoplakia as a clinical term only. The etiology of oral leukoplakia is multifactorial and many are idiopathic. The etiological role of candida in leukoplakia has been a subject of. Epstainbarr virus is the proven etiologic cause of nasopharyngeal carcinoma, oral hairy leukoplakia, lymphoproliferative disease, bcell lymphomas and. However, leukoplakia increases your risk of oral cancer. There is a strong association with tobacco smoking leukoplakia is six times more common in smokers than nonsmokers and alcohol intake independent of drinking pattern or beverage type. Lichen planus is a submucosal inflammatory lesion usually found on the cheeks. Differences e xist between pvl and homogeneous forms of leuk oplakia with re gards to epidemiology, clinical presentation, histopathology, and biologic behavior table i.
The clinical effect manifested in involution or shrinkage and loosening of the. Importantly, the development of oral hairy leukoplakia in an hivinfected individual is considered a clinical marker of severe immunosuppression and advanced hiv disease. Chronic smoking, pipe smoking, or other tobacco use. Leukoplakia 60% cured these are quite encouraging results. Leukoplakia usually doesnt cause permanent damage to tissues in your mouth.
Oral leukoplakia is more common in men than in women, with a maletofemale ratio of 2. May 19, 2017 this can help prevent the spread of the cancer. Tobacco role in the etiology of precancerous lesions. Oral leukoplakia, being a predominantly white change of the oral mucosa, is the. An update on etiology, pathogenesis, clinical presentation, diagnosis and management. Risk factors include all forms of tobacco use forms including cigar, cigarette. Leukoplakia is a condition wherein white or gray patches appear in some parts of the mouth, predominantly in the buccal mucosa and the tongue. Oral leukoplakia, as traditionally defined by the world health organization who, is a predominantly white lesion of the oral mucosa that cannot be characterized as any other definable lesion.
It is the most common hivaids related condition caused by ebv, although ebv associated lymphomas may also occur. Pdf oral premalignancy is considered as an intermediate stage. Leukoplakia definition a predominantly white lesion of the oral mucosa that cannot be characterized as any other definable lesion. Soames and southam reported mutations of p53 in the cells from dysplastic areas of some leukoplakias who smoke and drink heavily. It is also associated with betel quid chewing and oral submucous fibrosis how is the diagnosis made.
Oral leukoplakia is managed with regular oral examinations and if feasible, surgical excision. 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. Small patches can be removed by a more extensive biopsy using laser therapy or a scalpel. Oral leukoplakia is a premalignant lesion that long has been considered to confer increased risk for the development of oral cancer 1, 2. Leukoplakia causes, pictures, symptoms, treatment, prognosis.
In the context of lesions of the mucous membrane lining of the bladder, leukoplakia is a historic term for a visualized white patch which histologically represents keratinization in an area of squamous metaplasia. There is another form called hairy leukoplakia that, like oral thrush, affects those with weakened immune systems more adversely. May 10, 2019 leukoplakia is a condition in which thick, white or grayish patches form usually inside your mouth. Leukoplakia potentially malignant disorder of oral. That and other possible culprits, both mechanical and medical conditions will be mentioned as follows. The most effective methods of oral leukoplakia treatment. Feb 25, 2020 leukoplakia usually doesnt cause permanent damage to tissues in your mouth.
The use of complex phytoadaptogen in the treatment of patients with leukoplakia normalized expression of fasapo1 antigen and keratin 17. Physicians will usually biopsy oral leukoplakia lesions as 2040% of cases are precancerous or cancerous at the time of biopsy and another 815% become cancerous over. Oral hairy leukoplakia is a condition caused by epsteinbarr virus ebv and strongly associated with hiv infection. Mar 20, 2015 possible action mechanism for curcumin in precancerous lesions based on serum and salivary markers of oxidative stress journal of oral science vol. Oral hairy leukoplakia is a condition triggered by the epsteinbarr virus ebv. For this estimated rate, the author stefano petti, in a metaanalysis including 23 primary studies from all over the world published in the period 19862002 found no difference between geographical areas and between younger and older patients. Oral cancers often form near leukoplakia patches, and the patches themselves may show cancerous changes. Doctors help you with trusted information about leukoplakia in oral leukoplakia. 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. It has a multifactorial etiology but the most important factors are tobacco and alcohol, separately and synergically. Learn more from webmd about how leukoplakia is treated. Oral leukoplakia symptoms, diagnosis and treatment bmj. The patches it causes are usually softer than leukoplakia patches. The prognosis and overall survival of a patient with oral cancer is dependent on the early detection of any lesion that might identify a patient with higher risk than normal or with early infiltration before metastatic disease.
However, oral cancer is a potentially serious complication of leukoplakia. Multifactorial etiology of oral leukoplakia allows speaking not so much about the causes of disease, as much of the circumstances which cause it. Oral submucous fibrosis osmf, a precancerous condition of the oral cavity, has been studied by a number of workers in the field. Comparison and etiology as this case illustrates, pvl is a highrisk variant of oral leukoplakia with a propensity for malignant transformation. It was first described in 1984, just a few years after the aids epidemic started. In case of a possible etiologic factor, such as tobacco use or the. Oral white lesions are frequently encountered in daily practice. Clinical examination differentiates leukoedema from leukoplakia, lichen planus, white sponge nevus, and pathomimia morsicatio buccarum. Leukoplakia and erythroplakia of the oral mucosa a brief. However, leukoplakia is not limited as an oral disorder alone, as it may also appear in the genital area of the female. Leukoplakia management and treatment cleveland clinic.
However,severalpreexist ingconditionshavebeenfoundwith suchfrequencyinpatientswithoral cancerthattheymaybeconsidered,at. Oral leukoplakia is considered potentially malignant, with transformation rates in various studies and locations ranging from 0. 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. However, treatment is a challenge and results are often mixed. Leukoplakia is a premalignant lesion of the oral mucosa that presents as a white lesion or patch that cannot be characterized clinically or histopathologically as any other entity. Even after leukoplakia patches are removed, the risk of oral cancer remains higher than in the general population. Hairy leukoplakia mainly happens in adult males and is not as common in adult females. Diagnosis and treatment a doctor will usually diagnose leukoplakia by ruling out all other potential causes. The histologic appearance is similar to oral leukoplakia, with hyperkeratosis and possible dysplasia. The purpose of regular oral examination is to enable early diagnosis of oral squamous cell carcinoma. Objectives to provide an overview of the current thinking in terms of the diagnosis and management of oral leukoplakia and proliferative verrucous leukoplakia as relevant to general dental.
Hairy leukoplakia an overview sciencedirect topics. Aug 05, 2019 oral hairy leukoplakia ohl is a disease of the mucosa first described in 1984. The treatment may eliminate the lesions, but they may return, or there may be other negative outcomes. Surgical excision currently is the most commonly used treatment approach for oral leukoplakia. 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. Diagnostic challenges based on the present definition, a diagnosis of leukoplakia is onebyexclusionofknown,welldefinedlesionsanddisorders that may occur in the oral mucosa, as being listed in table 1 2.
Hairy leukoplakia creates fuzzy, white patches that can be mistaken for oral thrush. It has shown to be effective in the management of oral leukoplakia and in chemoprevention of oral cancer. Leukoplakia is different from other causes of white patches such as thrush or lichen planus because it can eventually develop into oral 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. Therefore, a process of exclusion establishes the diagnosis of the disease. The chemical, thermal or mechanical stimuli, which create conditions for the replacement of mucosal by keratinized epithelium include. The most commonly associated risk factor is the use of tobacco in either smoked or smokeless forms. Oral leukoplakia is a white patch or plaque that develops in the oral cavity and is strongly associated with smoking.
Leukoplakia of the oral mucosa is characterized by impairment of the epithelial differentiation program. Oral leukoplakia is a white patch or plaque that develops in the oral cavity and is strongly associated with tobacco smoking. Oral leukoplakia describes a white plaque that does not rub off and cannot be characterized as any other condition. Download a pdf about this oral disease which includes photographs. The cohort studies about oral leukoplakia are very rare, so it is difficult to appreciate its. Even after leukoplakia patches are removed, the risk of oral cancer remains. No case reported severe aggravation or any drug induced reaction. Oral leukoplakia and proliferative verrucous leukoplakia. Prevalence rates vary greatly in different countries and in different ethnic groups. Hairy leukoplakia is an unusual and severe form of leukoplakia and is a precancerous sore or lesion. Leukoplakia is the most common premalignant or potentially malignant lesion of the oral mucosa. Oral leukoplakia has a wide differential diagnosis, which is why an extensive workup is necessary to rule out other etiologies.
Possible action mechanism for curcumin in precancerous lesions based on serum and salivary markers of oxidative stress journal of oral science vol. Leukoplakiaa diagnostic and management algorithm journal of. Hairy leukoplakia is a result of infections stemming from the epsteinbarr virus ebv, which remains in the body for your lifetime. Oral leukoplakia international journal of oral health and medical. Leukoplakia potentially malignant disorder of oral cavity. A type of leukoplakia of the mouth, called oral hairy leukoplakia, is caused by the epsteinbarr virus.
Oral hairy leukoplakia can also appear in other people whose immune system is not working well, such as after a bone marrow transplant. The possible viral etiology of oral leukoplakia had been first suggested. Leukoplakia genetic and rare diseases information center. Cicatricial pemphigoid is a relatively uncommon blistering disease that mostly affects the mucous membranes, that is, the moist linings of the mouth, the eyes, the nose and throat, and the vagina.
Proliferative verrucous leukoplakia is a malignant form of leukoplakia of unknown etiology and is thought to be associated with human papilloma virus hpv. Sometimes ulcers can develop, but this represents little more than an irritating rash. More importantly, it is widely recognized as a precancerous lesion of oral squamous carcinoma. Oral cancer most commonly occurs in middleaged and older individuals, although a disturbing number of these malignancies is also being documented in younger adults in recent years. Additional clinical descriptions that may assist the characterization of oral leukoplakia are 6 etiological description. Hairy leukoplakia is one of the most common oral manifestations of hivaids, along with oral candidiasis.
Learn more about the symptoms, causes, diagnosis, and treatment. Leukoplakia could be classified as mucosal disease, and also as a premalignant condition. Leukoplakia is a condition in which one or more white patches or spots lesions forms inside the mouth. Oral leukoplakia ol is the most common potentially malignant disorder of the oral mucosa. When a biopsy is taken, the term leukoplakia should be replaced by the diagnosis obtained histologically. Sep 30, 2019 hairy leukoplakia lesions are painless and do not increase the risk of oral cancer. Hairy leukoplakia pictures, symptoms, causes, diagnosis. Although the etiology of oral leukoplakia is not fully understood, these lesions often are associated with carcinogenic exposures, such as from use of tobacco, alcohol, or, particularly in southeast asia, betel nut usually chewed 3, 4. Leukoplakiaa diagnostic and management algorithm joms. Epidemiologic and histologic study of oral cancer and leukoplakia among 50,915 villagers in india.
The available epidemiological data showed a clearcut geographical and ethnic predisposition, which suggested that certain customshabits prevalent among the population groups in southeast asia might be possible etiological factors. Oral leukoplakia ol is a white patch or plaque that cannot be rubbed off, cannot be characterized clinically or histologically as any other. A possible etiology and new treatment of burning mouth. The etiology of oral leukoplakia is multifactorial, and many causes are idiopathic. According to the american academy of oral medicine, erythroplakia and leukoplakia are generally considered precancerous or. Oral squamous cell carcinoma is a common malignancy worldwide and the most encountered oral malignant tumor 12. It has antioxidant activity, also acts by inhibition of cancer cell proliferation and interference with growth factor stimulation. Each year, scientists find out more about what causes the disease, how to prevent it, and how to improve treatment. High risk of intervening dysplasia and carcinoma developing. What is cicatricial pemphigoid sicuhtrishul pemfuhgoyd. Malignant transformation rates of oral leukoplakia range from 0. A clinical diagnosis of oral leukoplakia med oral patol oral cir bucal.
626 397 1529 634 1020 1419 1553 1081 583 622 956 1172 774 1584 267 534 357 394 522 1199 1109 245 195 544 486 1509 484 794 344 419 658 1135 347 1048 462 751 1377 776 1242 1053 191 799 1367 810 1024 1239