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Leukoplakia
Classification and external resources

The white lesion is an example of leukoplakia.
ICD-10 K13.2, N48.0, N88.0, N89.4, N90.4
ICD-9 528.6, 530.83, 607.0, 622.2, 623.1, 624.0
DiseasesDB 7438
MedlinePlus 001046
MeSH D007971

Leukoplakia is a clinical term used to describe patches of keratosis[1] . It is visible as adherent white patches[2] on the mucous membranes of the oral cavity, including the tongue, but also other areas of the gastro-intestinal tract, urinary tract and the genitals. The clinical appearance is highly variable. Leukoplakia is not a specific disease entity, but is diagnosis of exclusion.[3] It must be distinguished from diseases that may cause similar white lesions, such as candidiasis or lichen planus.

It is sometimes described as precancerous.[4]. It is also associated with smoking[5].

The term "candidal leukoplakia" is sometimes used to describe certain types of oral candidiasis.[6]

Although the term "leukoplakia" often applies to conditions of the mouth, it can also be used to describe conditions of the genitals and urinary tract[7].

Contents

Incidence and prevalence

Leukoplakic lesions are found in approximately 3% of the world's population. Like erythroplakia, leukoplakia is usually found in adults between 40 and 70 years of age, with a 2:1 male predominance.

Causes

Leukoplakia is primarily caused by the use of tobacco. Other possible etiological agents implicated are HPV , Candida albicans and possibly alcohol. Simultaneously serum levels of patients with leukoplakia were found to be low in Vit A,B-12,C & folic acid,in a study conducted in India. Most result from chronic irritation of mucous membranes by carcinogens.[citation needed] Bloodroot, otherwise known as sanguinaria, is also believed to be associated with leukoplakia.[8]

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.

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.[9]

See also

References

  1. ^ Underwood. General and Systemic Pathology. 4th Edition. Edinburgh, London: Churchill Livingstone 2004
  2. ^ leukoplakia at Dorland's Medical Dictionary
  3. ^ Mishra M, Mohanty J, Sengupta S, Tripathy S (2005). "Epidemiological and clinicopathological study of oral leukoplakia". Indian J Dermatol Venereol Leprol 71 (3): 161–5. PMID 16394403. http://www.ijdvl.com/article.asp?issn=0378-6323;year=2005;volume=71;issue=3;spage=161;epage=165;aulast=Mishra. 
  4. ^ Ishida K, Ito S, Wada N, et al (2007). "Nuclear localization of beta-catenin involved in precancerous change in oral leukoplakia". Mol. Cancer 6: 62. doi:10.1186/1476-4598-6-62. PMID 17922924. PMC 2140063. http://www.molecular-cancer.com/content/6//62. 
  5. ^ Underwood. General and Systemic Pathology. 4th Edition. Edinburgh, London: Churchill Livingstone 2004
  6. ^ Sitheeque MA, Samaranayake LP (2003). "Chronic hyperplastic candidiasis/candidiasis (candidal leukoplakia)". Crit. Rev. Oral Biol. Med. 14 (4): 253–67. PMID 12907694. http://cro.sagepub.com/cgi/pmidlookup?view=long&pmid=12907694. 
  7. ^ Underwood. General and Systemic Pathology. 4th Edition. Edinburgh, London: Churchill Livingstone 2004
  8. ^ Leukoplakia, (pdf format) hosted by the American Academy of Oral and Maxillofacial Pathology. Page accessed on December 19, 2006.
  9. ^ http://www.mayoclinic.com/health/beta-carotene/NS_patient-betacarotene

External links








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