Oral leukoplakia is the most common precancerous condition. After 50 years, leukoplakia is diagnosed in 1% of the population, while the incidence among men is twice as high as among women. Disease of the oral cavity is manifested by widespread or local lesions, which are grayish or white plaques of various localization. Pathology is characterized by a low-symptomatic and sluggish course with a gradual degeneration into a cancerous disease. Treatment is, first of all, the elimination of traumatization of the affected area and correction of causal pathology.
Leukoplakia is a lesion of the oral mucosa, accompanied by its increased keratinization (hyperkeratosis). It is characterized by the appearance of foci of compaction on the mucous membrane of the cheeks, tongue, corners of the mouth, a feeling of slight burning, itching and tightening. With the observance of hygienic measures and the sanitation of the oral cavity, the elimination of irritating factors, oral leukoplakia may disappear. Some forms of leukoplakia are susceptible to malignant degeneration and are subject to surgical excision.
People whose oral mucosa is often affected by various stimuli are more susceptible to the development of oral leukoplakia. These are mainly active smokers and people who abuse strong varieties of alcoholic beverages. Disease can occur due to the constant intake of hot and spicy food, spices. With prolonged use of certain medications, oral leukoplakia can manifest itself as a side effect, especially often it happens in elderly patients who take drugs of different pharmacological groups.
That is, any stimuli that cause the replacement of the mucous membrane with keratinized epithelium can cause oral leukoplakia of the oral cavity. Disease is not an independent disease, therefore, when whitish spots appear on the oral mucosa, a detailed examination should be carried out to find out the main cause of leukoplakia syndrome.
Irritation of the mucous membrane of the mouth and gums by the sharp edges of teeth or crowns is a constant traumatic factor, which can cause leukoplakia. Improperly installed or poor-quality dental prosthesis, especially in combination with other factors, is the main pathogenetic link in the development of leukoplakia and other oral diseases in many elderly patients. In patients with HIV infection, oral leukoplakia is diagnosed several times more often, as well as in patients who have been exposed to prolonged exposure to ultraviolet radiation during their lifetime.
Studies confirm that hereditary predisposition and the presence of human papillomavirus types 11 and 16 are important in the etiology of oral leukoplakia. Hypovitaminosis, iron deficiency anemia, diabetes mellitus and diseases of the gastrointestinal tract are the main endogenous causes of oral leukoplakia.
Leukoplakia syndrome can appear in any area where there is a mucous membrane. There are leukoplakia of the vagina, esophagus, cervix, bladder and oral cavity. Disease in the oral cavity is diagnosed earlier than in other organs. Early diagnosis allows you to prescribe treatment in time and prevent malignancy.
Depending on the location of the affected cells and the underlying cause of leukoplakia, the degree and type of keratinization of the epithelium may be different.
The lesion of leukoplakia consists of plaques of gray or white color. The diameter of the plaques is from 2 to 4 centimeters, their number is variable. Foci of leukoplakia are localized on the mucous membrane of the cheeks, lip adhesion, hard palate, gums and the bottom of the mouth. Usually, plaques do not rise above the surface of the oral mucosa, in addition, combined with general cyanotic activity, areas of leukoplakia may not be noticeable with inattentive examination.
In cases where the foci of leukoplakia rise above the surface, they have irregular scalloped outlines, sometimes sharp uneven corners. Often with such this disease, the surface of the foci is heterogeneous and ulcerated. The plaques are hard and rough to the touch.
Foci of leukoplakia form within a few months, although in most cases they become noticeable after two weeks. Externally, the areas of leukoplakia at the first stage rise and look slightly thickened. As time passes, they harden and become coarser. Soreness and other subjective sensations are absent, but sometimes areas of leukoplakia are more sensitive to stimuli, react more acutely to hot and cold food.
Leukoplakia is a sluggish pathology, usually its symptoms subside or increase over the years. However, leukoplakia does not accept reverse development; over time, the lesion area increases, cracks and ulceration appear, plaques turn brown and become denser. Such a degeneration is an unfavorable sign and is regarded as a precancerous condition or the beginning of degeneration into a cancerous disease of the oral mucosa.
Hairy leukoplakia is an atypical variant of the course of the disease and occurs mainly in HIV-positive patients and in patients with AIDS, sometimes hairy leukoplakia is observed in patients with an AIDS-associated symptom complex. Clinically, fleecy leukoplakia is characterized by the appearance of white plaques covered with villi. Since the areas of leukoplakia are more often located on the tongue, it should be differentiated from candidiasis stomatitis. Although in patients with HIV-positive status, hairy leukoplakia is often combined with candida stomatitis.
Diagnosis and treatment
During a visual examination, the dentist can make a preliminary diagnosis, but for an accurate diagnosis of oral leukoplakia, a biopsy must be performed. The biopsy is performed under local anesthesia, and the resulting material is examined in a cytological laboratory.
The tactic of treating oral leukoplakia is to eliminate the source of irritation. These are minimization or complete cessation of smoking, correction of dentures, restoration of teeth when their edges are broken off, sharpening of the sharp edges of the tooth. In cases where the causes of leukoplakia were internal diseases, cryodestruction of the affected areas, correction of the underlying disease and dispensary observation of the patient are indicated.
Disease is a precancerous condition of the mucosa, and if the spots of oral leukoplakia lose their luster, the surface becomes rough, covered with growths and ulcers, then, as a rule, the prognosis in these cases is unfavorable and oral leukoplakia degenerates into oral cancer. Approximately 10% of cases of leukoplakia of the oral mucosa end in malignancy.
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