leukoplakia

What is leukoplakia

In the medical field, the term leukoplakia means a relatively worrying condition: it is a lesion typical of the oral cavity, which mainly affects the surface of the tongue and the internal mucous membranes of the lips and cheeks; however, the mucous membranes of the larynx and genital organs could also be involved. Oral leukoplakia is the most common form, which is distinguished by the formation of rather unpleasant whitish plaques, often responsible for a perceptual alteration of the taste of food and discomfort within the mouth. Considering that oral leukoplakia is the most common and best known form, we will focus on this type.

Degeneration in cancer

Ideally, leukoplakia is considered an alarming condition, since it could generate a certain emotional impact, as well as causing a real constant discomfort in the mouth; however, it should be pointed out that leukoplakia is not always a precursor of malignant neoplasms, but this does not mean that it should be neglected, far from it.

Although it is rare that leukoplakia degenerates into cancer, it must still be considered a possible precancerous lesion, as it is visibly dissimilar from the normal oral mucosa, thus potentially convertible into a tumor. Medical statistics showed a malignant transformation of leukoplakia in 2-5% of affected subjects. However, it is impossible to predict with absolute certainty the evolution of the white plates under examination. However, science is currently progressing at great pace, given the search for cellular markers aimed at perfecting diagnostic criteria: these markers could be a valid aid to predict the possible neoplastic progression of leukoplakia.

Incidence

Literally, the term leukoplakia (or leukoplakia) means "white plate": the etymological analysis of the term allows us to anticipate the condition, which is precisely characterized by the appearance of whitish macules or plaques, distinguishable at sight and perceptible to the touch.

It is noted that leukoplakia is one of the most well-known and common "white lesions" affecting the buccal mucosa, as it can be found in approximately 3% of adults.

Leukoplakia is a phenomenon that could virtually affect anyone, especially smokers: many epidemiological investigations have been carried out, from which it emerged that male individuals represent the most risky category of leukoplakia precisely because they are more likely to smoke. The exceptions are certainly not lacking since, in some geographical areas, smoking is very common even among women.

Considering age, many cases of leukoplakia have been diagnosed among men over the age of 40 (especially those in their sixties); only 1% of those in their thirties are affected by leukoplakia.

Causes

To learn more: White Language, Causes and Symptoms

Focusing attention on a diagnosis by exclusion, leukoplakia cannot be ascribed to any actual pathology, nor to any other etiological factor of a physical-chemical nature, if not to tobacco [definition established by the WHO]; in other words, leukoplakia represents a typical lesion related to smoking, often reversible simply by stopping smoking.

However, in addition to tobacco smoke, some hypothesized and plausible predisposing factors have been identified, although the direct correlation with leukoplakia has not yet been established. Among these stand out:

• systemic diseases (diabetes mellitus, iron deficiency anemia, liver dysfunction, etc.);
• allergies to materials used for daily oral cleaning;
• allergic reactions to instruments used by the dentist;
• abuse of alcoholic beverages;
• minor trauma but repeated over time;
• bacterial infections.

In severe cases, leukoplakia may prove to be a lit spy of AIDS.

Symptoms

The risk factors described above contribute to the formation of white plaques adjacent to the mucosa: at an oral level, leukoplakia tends to localize mainly at lingual, gingival, mucosal-labial and vestibular level. In general, the lingual plates create the typical white tongue, furrowed by apparently bloody reddish streaks, responsible for the striped, almost zebra-striped appearance of the tongue itself.

Morphologically, leukoplakia can be divided into three forms:

1. Homogeneous flat leukoplakia : the plaque is flat and slightly rippled, with white spots interposed to reddish arborescent streaks. The risk of evolution of the lesion in a negative sense is unlikely but possible (risk index estimated at around 0.2-4%). In most cases it is asymptomatic. In similar situations, one speaks of hyperorto-keratosis or hyperpara-keratosis, since the lesion is characterized by an abnormal accumulation of keratin.
2. Verrucous leukoplakia : the superficial film covering the plaque is irregular and characterized by evident ramifications.
3. Uneven fissured leukoplakia: the lesion appears nodular, often also accompanied by erythro-leukoplakia (pre-neoplastic form, with possible malignant evolution 5 times higher than the previous form). It often causes limited pain / discomfort.