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Leukoplakia

Leukoplakias


Presentation

  • The authors present a case of proliferative verrucous leukoplakia (PVL) in a 78-year-old man. It was initially presented as leukoplakia on the tongue but a microscopic investigation in 1991 revealed it to be a mild epithelial dysplasia.[ncbi.nlm.nih.gov]
Infectious Mononucleosis
Tenesmus
  • She was having difficulty in evacuation, with a decreasing stool caliber and tenesmus. She denied any history of rectal trauma, pruritus, laxative use, perianal abscess, or fistula. The clinical examination and laboratory data were normal.[doi.org]
Tongue Ulcer
  • Ulcerated oral leukoplakia Verrucous oral leukoplakia White sponge nevus of mucosa Clinical Information A white patch or plaque on oral cavity mucosa that cannot be characterized clinically or pathologically as any other disease.[icd9data.com]
  • Case 1 37-year-old male with recent diagnosis of HIV infection Not yet started on anti-retroviral medications Elevated viral load and reduced CD4 lymphocyte count (240) Presents for evaluation and management of long-standing “tongue ulcers” with concern[derm101.com]
Withdrawn
  • Jiang Ying, Feilong Wang and Juhong Lin, WITHDRAWN: Human papillomavirus 16 as a risk factor for oral leukoplakia: A meta-analysis, Meta Gene, (2016).[doi.org]
Responsiveness Decreasing
  • We dichotomised data: clinical resolution vs partial or no clinical response; decreased severity vs worsening of histology or no change in histological features.[doi.org]
Dizziness
  • Minor adverse events included dizziness, diarrheoa and abdominal pain. No participants had grade 4 adverse events. Four participants (two from the placebo group and two from an intervention group) had grade 3 adverse events.[doi.org]
Dysesthesia
  • It is characteristically asymptomatic, though patients may complain of dysgeusia, dysesthesia, mild pain, or concerns regarding cosmetic appearance.[derm101.com]

Treatment

  • RESULTS: Patients underwent a median of 2 (range: 1-6) in-office laser treatments. Time between treatments was median 7.6 months.[ncbi.nlm.nih.gov]
  • […] and 1 evaluated topical treatment.[doi.org]

Prognosis

  • Prognosis is poor for this seemingly harmless-appearing white lesion of the oral mucosa.[ncbi.nlm.nih.gov]
  • In addition, some dysplastic lesions may have a worse prognosis than isolated carcinomas without leukoplakia. However, dysplastic lesions can regress spontaneously. Therefore, the behaviour of dysplastic lesions is unpredictable.[patient.info]
  • Floor of the mouth is the are with worst prognosis followed by the tongue and then Lips. About 50% of the lesions in floor of the mouth show features of epithelial dysplasia, carcinoma in situ and invasive carcinoma.[juniordentist.com]

Etiology

  • INTRODUCTION: Proliferative verrucous leukoplakia is a multifocal and progressive lesion of the oral mucosa, with unknown etiology, and commonly resistant to all therapy attempts with frequent recurrences.[ncbi.nlm.nih.gov]
  • Evil of seven “S” namely Smoking Spirits Spices Sepsis Sharp tooth edges Syphilis Susceptibility ETIOLOGICAL FACTORS Tobacco Chronic irritation Alcohol Dietary components & deficiency states Tertiary syphilis Actinic radiations Viral agents Candidal[intelligentdental.com]

Epidemiology

  • Our results regarding the epidemiology of OL showed a similar trend to those reported in western populations and provided preliminary epidemiological information on the Chinese population.[ncbi.nlm.nih.gov]
  • System(s) affected: gastrointestinal Hyperplasia of squamous epithelium Epidemiology Develops in middle age, increases with age Most common in India, where more people smoke and chew tobacco and areca nuts Prevalence 0.1–0.5% of the adult population is[unboundmedicine.com]
  • Epidemiology Frequency International OL occurs in fewer than 1% of individuals. Mortality/Morbidity OL is considered to be potentially malignant, with a transformation rate in various studies and locations that range from 0.6 to 20%.[emedicine.medscape.com]
  • Epidemiology Prevalence - the estimated worldwide prevalence is 2% [ 4 ] . Most cases of leukoplakia occur at age 50-70 years. Less than 1% of patients are under the age of 30 years [ 5 ] .[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • Etiology and Pathophysiology Hyperkeratosis or dyskeratosis of the oral squamous epithelium Tobacco use in any form Alcohol consumption/alcoholism Periodontitis Candida albicans infection may induce dysplasia and increase malignant transformation.[unboundmedicine.com]
  • Thus, idiopathic leukoplakia is considered a premalignant lesion. [1, 2] Pathophysiology The etiology of most cases of OL is unknown (idiopathic).[emedicine.medscape.com]
  • Edit Stepwise progression from normal tissue to precancerous lesion to invasive cancer The pathophysiology of precancerous lesions is thought to be similar to that of cancer, and varies depending on the disease site and type of lesion. [11] It is thought[en.m.wikipedia.org]

Prevention

  • Green tea is well known for its preventative use against cancer, which is why it seemed logical to attempt to use it to prevent oral leukoplakia. Studies have shown that EGCG is the most effective compound at preventing cancer (chemopreventative).[oxfordvitality.co.uk]
  • Prevention You may be able to prevent leukoplakia if you avoid all tobacco products or alcohol use. Talk to your doctor about methods to help you quit. If you continue to smoke or chew tobacco or drink alcohol, have frequent dental checkups.[mayoclinic.org]
  • Regular dental care can help prevent recurrences. Learn more about spots on the tongue. Share on Pinterest Leukoplakia is marked by unusual-looking patches inside your mouth.[healthline.com]
  • Regular dental check-ups to avoid bad restorations Diet rich in fresh fruits and vegetables may help to prevent cancer. HPV vaccination may be preventive. Commonly Associated Conditions HIV infection is closely associated with hairy leukoplakia.[unboundmedicine.com]

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