LEUKOPLAKIA

• Leukoplakia is described as any white patch or plaque that cannot be rubbed off or characterised clinically or pathologically as another lesion.
• It is the most common premalignant lesion.

  

ETIOLOGY-

• 6 S

1. Smoking
2. Spirit (alcohol)
3. Spices (tobacco), betel nut
4. Sepsis
5. Sharp tooth
6. Syphilis
7. Oral candidiasis (candida albicans)

  

PATHOLOGY

• Microscopic features are-

1. Hyperkeratosis- milky blush on the surface
2. Acanthosis- elongation of rete pegs (smooth dry patch)
3. Parakeratosis- cell are still immature
4. Dyskeratosis- forms keratin cell layers in epidermis
5. Carcinoma in situ- epithelial pearls seen in dermis.

  

 

CLINICAL FORMS OF LEUKOPLAKIA-

1. Homogenous
2. Non homogenous
3. Proliferative verrucous
4. Erythroplakia
5. Sublingual keratosis
6. Oral hairy leukoplakia (Epbstein- Barr virus)
7. Syphilitic leukoplakia

  

CLINICAL FEATURES-

• Seen in middle aged and elderly person
• More common in males.
• Sites- Buccal mucosa, angle of mouth, alveolar mucosa, tongue, lip, hard & soft palate and floor of the mouth.

 

HISTOLOGY-

• Lesion appears white, whitish- yellow, red- velvety
• Usually are circumscribed, slightly elevated, smooth and wrinkled, speckled or nodular.
• Histological features are hyperkeratosis, dysplasia & anaplasia with nuclear & cellular pleomorphism.

  

INVESTIGATION-

• Biopsy to rule out malignancy

 

TREATMENT-

• Severe dysplasia or carcinoma in situ is excised surgically or CO₂ laser is used.
• Leukoplakia in vulva treated by Simple vulvectomy; and Estrogen cream.

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