What is Leukoplakia

Overview

Leukoplakia is a white plaque or patch of questionable risk that may or may not develop into cancer. It is found inside the mouth, commonly affecting the vestibule, palate, lateral surface of the tongue and gums. Tonsils, soft palate, and other parts can also be affected. 

Types

Leukoplakia is of two types:

• Homogenous: A white, evenly coloured thin patch with a smooth, wrinkled, or ridged surface. This surface is consistent throughout the lesion.
• Non-homogenous: This type is mainly white or maybe a white-and-red, irregularly shaped patch. It can be flat, nodular, or verrucous.
• Other forms are ulcerated and nodular or speckled.

 Proliferative verrucous leukoplakia (PVL) is a rare but aggressive form of oral leukoplakia. It is associated with the Epstein-Barr virus, a type of herpes virus. 

 Yet another condition, termed oral hairy leukoplakia, also occurs due to the Epstein-Barr virus. It has hairy patches that appear like hair emerging out of the folds in the tongue.  

Causes

Leukoplakia is caused by or has been associated with the following conditions:

• Heavy smoking
• Chewing areca nut (betel nut)
• Use of chewing tobacco or snuff dipping 
• Smoking and drinking together 

Some cases that have no evident cause are known as idiopathic leukoplakia.

Symptoms

Leukoplakia typically affects the gums, cheeks, vestibule, and floor of the mouth or tongue. Its symptoms are:

• Painless mass that may or may not grow with time.
• A white patch appears in the mouth that is asymptomatic and often goes unnoticed unless it interferes with functioning.
• Irregular or flat-textured
• Thickened or hardened in areas
• It may occur along with raised, red lesions, also known as speckled leukoplakia or erythroplakia. This form is more likely to become malignant.)

Diagnosis

Leukoplakia is a clinical term. Hence, it does not require a diagnosis. Any patch or white, unescapable white mass is termed leukoplakia. On histopathological examination using the biopsy method, the actual disease will be revealed. 

Treatment

Leukoplakia needs to be treated to prevent it from turning into cancer. Only after a proper histopathological examination will the actual disease be revealed, and a specific treatment plan can be formulated. Most lesions heal after a surgical or conventional intervention. However, a few may recur depending on the cause and stage. This condition can be managed in two ways:

Conventional treatment

• Avoid chewing tobacco or areca nut
• Consume a diet rich in antioxidants and vitamins, and minerals
• Oral retinoids also help lower the chances of recurrence
• Multivitamin supplements also help improve the condition.

Surgical treatment

Lesions are often removed using surgical methods or lasers. Other methods are:

• Photodynamic therapy (light-activated cancer drugs)
• Electrocauterization (Heating therapy)
• Cryotherapy (freezing therapy)

Prevention

Some ways to prevent leukoplakia are:

• Avoid smoking and drinking
• Consume fruits and vegetables
• Multivitamin supplements must be taken in case of vitamin deficiency.