• Leukoplakia

    (Hairy Leukoplakia; Smoker’s Keratosis)

    Definition

    Caused by chronic irritation, leukoplakia is a disorder of the mouth’s mucus membranes. White patches form on the tongue or inside of the mouth over weeks or months. This can also occur on the vulva in females, but for unknown reasons. One type, known as hairy leukoplakia, is a type found primarily in people who have HIV or other types of severe immune deficiency. Most cases of leukoplakia get better once the source of the irritation is removed. In rare cases, though, the condition can lead to oral cancer. If you notice any signs, see your dentist or doctor.

    Causes

    Hairy leukoplakia results from a virus that becomes active in the body when the immune system becomes weak. Infection may play a role in other cases, as well. Leukoplakia usually results from irritants, such as:
    • Pipe or cigarette smoking
    • Chewing tobacco or snuff
    • Rough teeth
    • Rough places on dentures, fillings, or crowns

    Risk Factors

    These risk factors increase your chance of developing leukoplakia. Tell your doctor if you have any of these risk factors:
    • Age: older than 65
    • Sex:
      • More men than women get leukoplakia.
      • In women, the condition more often develops into cancer.
      Lifestyle:
      • Tobacco use (especially smokeless tobacco)
      • Long-time alcohol use
    • Having a weakened immune system (eg, HIV)

    Symptoms

    In some cases, leukoplakia resembles oral thrush , an infection also associated with HIV/AIDS and lowered immune function. Leukoplakia is usually harmless, but sometimes leads to cancer. If you have any of these symptoms for more than a week, see your dentist or doctor:
      Lesion on the tongue or gums, inside of the cheeks, or on the vulva
      • White, gray, or red in color
      • Thick, slightly raised, or hardened surface
    • Sensitivity to touch, heat, or spicy foods
    • Pain or other signs of infection
    • With hairy leukoplakia: painless and fuzzy, white appearance
    Oral Thrush—Resembles Leukoplakia
    Thrush
    Copyright © Nucleus Medical Media, Inc.

    Diagnosis

    In most cases, a dentist can diagnose leukoplakia with a mouth exam. To confirm a diagnosis or to check for cancer, an oral brush biopsy may be needed. This involves removing some cells with a small brush. It takes only minutes and is painless. A pathologist then checks these cells for signs of cancer. Sometimes the dentist uses a scalpel to remove cells after numbing the area.

    Treatment

    Talk with your doctor about the best treatment plan for you. Treatment options include:
    • Removing the irritant—Quitting smoking or correcting dental problems often takes care of the problem.
    • Removing patches—If the problem persists, or if signs of cancer are present, your dentist or doctor may need to remove patches of leukoplakia.
    • Taking medicine—For hairy leukoplakia, the doctor may prescribe antiviral medicines. These include valacyclovir and famciclovir . Or, the doctor may prescribe a topical solution, such as podophyllum resin.

    Prevention

    To help reduce your chance of getting leukoplakia, take the following steps:
    • If you smoke, quit .
    • Avoid or limit your use of alcohol.
    • See a dentist regularly, especially if you have rough places in your mouth.
    • Eat plenty of fruits and vegetables , which are full of antioxidants.

    RESOURCES

    American Dental Association http://www.ada.org/

    National Institute of Dental and Craniofacial Research http://www.nidcr.nih.gov/

    CANADIAN RESOURCES

    Canadian Dental Association http://www.cda-adc.ca/

    Canadian Dental Hygienists Association http://www.cdha.ca/

    References

    AETC National Resource Center. Oral hairy leukoplakia. AETC National Resource Center website. Available at: http://www.aids-ed.org/aidsetc?page=cm-525a%5Fohl . Updated July 2006. Accessed November 10, 2010.

    DermNet NZ. Hairy leukoplakia. DermNet NZ website. Available at: http://dermnetnz.org/site-age-specific/hairy-leukoplakia.html . Updated July 5, 2010. Accessed November 10, 2010.

    Mayo Clinic. Leukoplakia. Mayo Clinic website. Available at: http://www.mayoclinic.com/invoke.cfm?id=DS00458 . Updated November 2, 2010. Accessed November 10, 2010.

    Revision Information

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