Leukoplakia
Leukoplakia is a condition characterized by the formation of white patches on the mucous membranes of the mouth, which can also appear on the vulva in women. This disorder typically arises from chronic irritation due to factors such as smoking, tobacco use, rough teeth, or ill-fitting dentures. A specific type known as hairy leukoplakia can occur in individuals with weakened immune systems, such as those living with HIV. While leukoplakia may not always be serious, there is a risk of it developing into cancer, especially in women, with approximately 9% of cases leading to malignancy.
Symptoms can include thick, raised lesions that may be sensitive to touch or certain foods. Diagnosis is usually made through a dental examination, and further testing may involve a biopsy to check for cancerous changes. Treatment often focuses on removing the source of irritation and may include medications, especially for hairy leukoplakia. Preventive measures such as quitting smoking, maintaining good oral hygiene, and regular dental check-ups can help reduce the risk of developing leukoplakia.
Leukoplakia
ALSO KNOWN AS: Smoker’s keratosis
DEFINITION: Caused by chronic irritation, leukoplakia is a disorder of the mouth’s mucous membranes. White patches form on the tongue or inside of the mouth over weeks or months. This can also occur on the vulva in females, but for unknown or unrelated reasons.
Causes
Leukoplakia is caused by chronic irritation. Irritants can come from pipe or cigarette smoking, chewing tobacco or snuff, rough teeth, and rough places on dentures, fillings, or crowns. One type, known as hairy leukoplakia, results from a virus that becomes active in the body when the immune system is weak. This is found primarily in people with the human immunodeficiency virus (HIV) or other types of severe immune deficiency. Infection may play a role in other cases, as well. Most cases of leukoplakia get better once the source of the irritation is removed.
Risk Factors
Risk factors that increase the chance of developing leukoplakia are old age (sixty-five years or older); lifestyle, such as tobacco use or long-time alcohol use; and a weakened immune system. Though more men than women are at risk of developing leukoplakia, the condition more often develops into cancer for women. Roughly 9 percent of people who develop leukoplakia develop cancer.
Symptoms
Symptoms can include a lesion on the tongue or gums, inside of the cheeks, or on the vulva. The lesion can be white, gray, or red in color, and is typically thick and slightly raised, or it may have a hardened surface. Other symptoms include sensitivity to touch, heat, or spicy foods, as well as pain or other signs of infection. With hairy leukoplakia, painless and fuzzy white patches appear on the tongue. In some cases, leukoplakia resembles oral thrush, an infection also associated with HIV/AIDS and lowered immune function.
Screening and Diagnosis
In most cases, a dentist can diagnose leukoplakia with a mouth exam. To confirm a diagnosis or to check for cancer, an oral brush biopsy may be needed. This involves removing some cells with a small brush. A pathologist then checks these cells for signs of cancer. Sometimes the dentist uses a scalpel to remove cells after numbing the area.
Treatment and Therapy
Leukoplakia can be treated by removing the irritant, which may involve quitting smoking, correcting dental problems, removing patchesparticularly if signs of cancer are presentand by taking medication. Oral medicines include valacyclovir and famciclovir, though topical solutions, such as podophyllum resin, are also effective. For hairy leukoplakia, the doctor may prescribe antiviral medicines on top of recommending the irritant be removed.
Prevention
Smoking cessation, limiting or avoiding alcohol use, good oral hygiene, regular visits to the dentist, and consuming plenty of fruits and vegetables (full of antioxidants) are all effective methods of reducing the chance of developing leukoplakia.
Websites of Interest
American Dental Association
http://www.ada.org/
National Institute of Dental and Craniofacial Research
http://www.nidcr.nih.gov/
Bibliography
"Leukoplakia." American Osteopathic College of Dermatology, www.aocd.org/?page=Leukoplakia. Accessed 17 Feb. 2017.
“Leukoplakia.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 26 July 2013, www.mayoclinic.org/diseases-conditions/leukoplakia/basics/definition/con-20023802. Accessed 17 Feb. 2017.
"Leukoplakia." MedlinePlus, US National Library of Medicine, 10 Sept. 2015, medlineplus.gov/ency/article/001046.htm. Accessed 17 Feb. 2017.
“Leukoplakia.” UMMC, University of Maryland Medical Center, 2011, umm.edu/health/medical/ency/articles/leukoplakia. Accessed 30 Mar. 2012.
Mohammed F. Fairozekhan. “Oral Leukoplakia.” StatPearls, 17 July 2023, www.ncbi.nlm.nih.gov/books/NBK442013/. Accessed 23 Aug. 2024.
“Oral Hairy Leukoplakia.” AETC National Resource Center, AIDS Education & Training Centers National Resource Center, 2012, aidsetc.org/guide/oral-hairy-leukoplakia. Accessed 30 Mar. 2012.