Leukoplakia

Introduction to mucosal leukoplakia Leukoplakia refers to a white keratotic disease that occurs in the mucous membranes of the mouth or vulva. Oral mucosal leukoplakia is more common in men than middle-aged men. Vulvar leukoplakia is more common in women after amenorrhea. It is characterized by punctate, flaky or strip-like gray or creamy keratotic patches, which have a tendency to become squamous cell carcinoma. It is estimated that the malignant rate is about 2%, and the highest is 4% to 6%. It is advisable to use a combination of local and systemic treatments, and patients with cancer should be removed early. basic knowledge The proportion of the disease: the disease is rare, the incidence rate is about 0.0001% - 0.0003% Susceptible population: Oral mucosal leukoplakia is more common in men than middle-aged men, and vulvar leukoplakia is more common in women after amenorrhea Mode of infection: non-infectious complication:

Mucosal leukoplakia

(1) Causes of the disease

It is not completely clear, and it is related to certain systemic factors such as diabetes, endocrine disorders, malnutrition, vitamin deficiency, etc. Local factors are also important. White spots occurring in the oral mucosa are more common in men and are considered to be related to mass smoking. Or related to oral hygiene, tooth position, dentures, diseased tooth stimulation, female leukoplakia is more common in menopausal women, associated with endocrine changes, long-term stimulation of vaginal discharge.

(two) pathogenesis

Early keratosis or parakeratosis, thickened granular layer, irregular hypertrophy of the spinous layer, keratinized cells, good cell differentiation, basal liquefaction degeneration, lymphocyte-based inflammatory cell infiltration in the upper dermis, late Epithelial cell changes occur, and basal cells liquefy or disappear.

Mucosal leukoplakia prevention

1. Correct unhealthy lifestyles, such as quitting smoking, sticking to mouthwash or brushing after meals, keeping the vulva clean.

2. Active treatment of dental diseases and other vaginal disorders.

3. Actively remove stimulating factors, timely treat local infections and skin diseases; actively treat diabetes.

4. Eat more fruits rich in vitamins such as kiwi, lemon, carambola and vegetables and carrots.

Mucosal leukoplakia complications Complication

Since the stratified squamous epithelial tissue of the lesion is destroyed, the friction is reduced, so erosion or ulceration may occur at the lesion. The skin integrity is destroyed, so the skin bacterial infection or fungal infection can be induced by the patient's scratching, usually secondary to low body constitution, or long-term use of immunosuppressive agents and fungal infections such as nail fungus, such as concurrent bacterial infection may have fever , skin swelling, ulceration and purulent secretion and other performance. Severe cases can lead to sepsis, which should be brought to the attention of clinicians.

Mucosal leukoplakia symptoms common symptoms mucosa slightly pale oral mucosal leukoplakia vascular atrophic leukoplakia pruritus vulva leukoplakia eczema

Oral mucosal leukoplakia

(1) Good hair and parts: good lips, cheeks, upper jaw, tongue back and gum mucosa.

(2) Symptoms: The lesions are punctate, flaky or strips of grayish or milky keratinized patches. The boundary is clear, hypertrophic and infiltrated. The surface of the lesion may have a milky white luster at the early stage, which changes in a mesh shape and sometimes forms a white color. Membrane, adhesion is firmer, forcibly stripped and bleeding, the surface of the lesion becomes rough, cracks and ulcers, and there is no self-consciousness, sensitive to hot and cold stimuli, painful after forming a crack or ulcer.

2. Female leukoplakia

(1) Good hair and parts: skin lesions occur in the labia minora, clitoris, the inside of the labia majora, the vaginal opening and the vaginal vestibule, etc., do not involve the outside of the labia majora and the perianal, the labia minora does not shrink, the skin outside the mucosa Not involved.

(2) Symptoms: skin lesions are white or gray, gray-blue, purple-red keratotic patches, single or multiple, the damage characteristics are similar to oral mucosal leukoplakia, most patients with local itching, due to scratching can be secondary Eczema-like changes, mossy, chapped, ulcers can cause stenosis of the vulva.

It is generally believed that this disease is a precancerous lesion. 5% to 10% of patients with long-term unhealed cancer can develop cancer. Very few men can also develop mucosal leukoplakia, which mainly occurs in the glans mucosa and may involve the inside of the foreskin.

Examination of mucosal leukoplakia

Skin examination: punctate, patchy or strips of gray or creamy keratotic patches with clear boundaries and hypertrophic infiltration. The surface of the skin lesion may have a milky white luster in the early stage, which changes in a mesh shape, and sometimes forms a white film, which is firmly adhered and forcibly stripped to bleed.

Histopathological changes: the epidermis is hyperkeratotic, the keratin is prominent on the surface (often similar to hairy), the keratinization is incomplete, the acanthosis is thick, and the upper part of the spinous layer below the parakeratosis is bulky, lightly stained, and nuclear pyknosis. Balloon-like cells, there is little inflammation in the dermis.

Diagnosis and differentiation of leukoplakia

diagnosis

According to clinical features, age and histopathological features can be diagnosed.

Differential diagnosis

Lichen planus

Oral mucosal leukoplakia should be identified mainly with lichen planus. The lichen planus rash is needle or rice-like size, milky white, polygonal flat papules, scattered or fused into a mesh or ring, more common around the buccal mucosa bite line, scattered around The purple-red polygonal papules are often accompanied by other skin lesions, and pathological changes are characteristic.

2. syphilitic mucosal leukoplakia

Although it occurs in the oral mucosa, it can also be found in the genital and anal mucosa. It is a gray or milky white flat plaque. The surface is often eroded and can develop into an ulcer. The ulcer base is covered with a dark black film. The smear of the white spot surface can be checked. To the Treponema pallidum, and in addition to mucosal leukoplakia, the patient is accompanied by other symptoms of syphilis, a history of unclean sexual intercourse, syphilis seropositive.

3. Mucosal white sponge

More common in newborns and children, is a hereditary disease, a small number occurs in adolescence, the lesion affects the entire oral mucosa, and the damage is spongy grayish white spots.

4. Hardening atrophic moss

Sclerosing atrophic moss is clinically difficult to distinguish from female leukoplakia, but the pathological changes are completely different.

5. Vitiligo

Although vitiligo can occur in the female vaginal mucosa, but only the pigmentation loss spots, no itching, can be extended to the pubic area, pubic hair can be white, white lesions without keratosis and hypertrophy, no invasive lesions, other skin There may also be vitiligo-like lesions, and the pathological changes are only the disappearance of melanin in the basal layer.

6. Neurodermatitis

Neurodermatitis occurs mostly in the labia majora and the vulva skin. It does not occur in the mucous membranes, itching is severe, and the skin lesions are lichen-like.

7. Candidiasis

Children mostly occur in the mouth and can also occur in women's genitals. The lesions in the mouth are creamy white patches of varying sizes, which are easy to exfoliate. It occurs in the female genitals as white flaky film spots, mostly in the labia minora. The medial mucosa, accompanied by leucorrhea abnormalities, such as bean dregs or curd-like, itching is obvious. In severe cases, symptoms such as frequent urination, urgency, and dysuria may occur. Whether it is white or candidiasis in the mouth or female genital area, its white film The smear microscopy was positive for fungi and sensitive to fungal drugs.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.