What is Leukoplakia?
Leukoplakia is the medical term used to describe a condition in which patches of accumulations of keratin emerge on mucous membranes in some areas of the body, usually inside the mouth. The condition is made evident through the presence of flecks of white that can be found attached onto the gums, the floor of the mouth, the inside of the cheeks, or on the tongue. The growths are not however limited to the oral cavity alone and can at times also be found within other section of the gastro-intestinal tract or on the genital areas. These plaque-like lesions that form in leukoplakia cannot be scraped off, unlike in other conditions that also exhibit whitish lesions that appear on the oral mucosa, such as in oral thrush or candidiasis.
The patces of leukoplakia can develop at any age but it is most common in the elderly. The condition is also more common in males than in females. The specific cause of the condition is not yet known however the lesions have been found to grow as a result of the constant irritation brought on by tobacco in any form, regardless of whether the substance is smoked or chewed. Leukoplakia is not usually an alarming condition, but 4% of the total leukoplakia cases have been found to be precancerous and cancerous manifestations in the oral mucosa have also been found to lie next to areas affected by leukoplakia. The condition can thus predispose an individual to a more severe disease such as cancer so immediate treatment should be received if signs of the growths are detected.
The clinical appearance of the patches that grow in leukoplakia are not consistent, so the growths can take on different forms. It is for this reason that the condition is merely a diagnosis of exclusion, meaning the diagnosis of leukoplakia is only arrived at if no other types of conditions or illnesses can be determined. Leukoplakia lesions can have the following characteristics:
- Lesions grow gradually and slowly over a period of time that can range from weeks to months
- Lesions grow on gums, on the inside areas of the cheeks, on the tongue, or on the bottom of the mouth
- Patches are of a white or greyish color
- Lesions can not be rubbed off or scraped off
- Lesions are irregularly shaped
- Lesions can be flat but can also be rough and textured
- Patches are thick and hardened
- Lesions may be sensitive to touch and to extreme temperatures or spicy food
Precancerous leukoplakia lesions have the distinct characteristic of being red in color. This is known as erythroplakia.
Another subtype of leukoplakia that exists is called hairy leukoplakia due to the “hairy” appearance of the lesions.
These growths are:
- Present in people whose immune systems are compromised, such as in the cases of individuals who take immunosuppressive drugs or people who have illnesses like AIDS.
- Lesions in hairy leukoplakia are fuzzy and white
- Lesions look like folds found on the sides of the tongue
Leukoplakia and its variant, hairy leukoplakia are caused by different triggers. Ordinary leukoplakia is not completely understood so its definite cause is yet to be determined, but the condition is found to be present in individuals who frequently use tobacco. The tobacco may either be chewed or smoked, but regardless of the method of use, tobacco has been found to prompt the development of the lesions – especially within the oral cavity. 3 out of 4 tobacco users develop leukoplakia later on in their lives, and this is especially the case in tobacco users who like to hold the tobacco pressed against the inside of their cheeks. Chronic consumption of alcohol is also an identified irritant.
The development of hairy leukoplakia on the other hand is associated with a previous infection to the EBV or Epstein-Barr virus. The EBV is a type of virus that persists within the body for a person’s entire lifetime. A person can adapt to the presence of the virus and not manifest any signs of disease as the virus simply remains dormant; but once the immune system is weakened by any means, the virus takes advantage of this window of opportunity and becomes activated. This series of events has often lead to cases of hairy leukoplakia.
Diseases that cause severe deterioration of the immune system can precede incidences of hairy leukoplakia. Individuals with HIV or AIDS are very prone to the condition. Medications made specifically for the growth of the lesions are however available, but hairy leukoplakia is still present in many patients affected with HIV. Hairy leukoplakia is also treated as a sign that a person may have HIV.
The most important factor in a patient’s treatment for leukoplakia is getting rid of the factors that may be causing the development of the lesions. Some people get rid of the patches simply by stopping their use of tobacco, alcohol, and other irritants. If however this proves to be ineffective, the patient must undergo other forms of treatment especially if the lesions are showing signs of the earliest stages of cancer.
Leukoplakic patches can be removed surgically. A scalpel, laser, or a probe that has an extremely cold temperature can be used to destroy the cells of the lesions. However follow-up visits must be religiously observed since recurrences are not uncommon.
Leukoplakia can be relatively harmless if the condition is caught early enough. Small lesions can be helped through regular checkups and followups and the patient must also take responsibility for regularly inspecting his or her own mouth for any suspicious growths that may look abnormal.
Some forms of treatment that have been tried for leukoplakia include the use of Vitamin A derivatives. These are the treatments also used for acne or skin problems, but unfortunately, these have not been found effective for leukoplakia.
Hairy leukoplakia is approached with different treatment methods. The patient can take medications such as antiviral drugs like valacyclovir or famciclovir if he or she developed leukoplakia due to the presence of the Epstein-Barr virus. These drugs are capable of halting the virus from replicating any further but they are unable to kill off the virus from the body entirely. The antivirals help clear away the patches but recurrences are still possible.
Applying topical drugs onto affected areas is also used to treat hairy leukoplakia. Tretinoin and podophyllum resin solutions are used for this purpose. The medications must be maintained, otherwise, the lesions simply reappear.
Photos, Images and Pictures of Leukoplakia…