White, hard, raised plaques on the oral mucosa

Introduction Plaque leukoplakia: White or grayish white homogeneous hard plaques on the oral mucosa, tight texture, varying lesions and areas, mild bulges or unevenness. It is worth noting that there is no parallel relationship between the size of the lesion and the likelihood of cancer, and sometimes it is cancerous even if only the size of the rice is large. It is often difficult to distinguish the leukoplakia from the plaque lesions, but the former is harder. It is a clinical manifestation of oral leukoplakia. Leukoplakia refers to plaque-like lesions of white or gray-white keratotic lesions that only occur on the mucosa. Such plaques on the oral mucosa cannot be rubbed off, and cannot be clinically or histopathologically Among the other disease categories, it is a common non-infectious chronic disease.

Cause

Local stimulating factors play an important role in the pathogenesis of leukoplakia. Smoking is a common cause. People with leukoplakia have a smoking habit of 80% to 90%, and the location of the disease is more consistent with the stimulation of the smoke. Others such as chewing betel nut, wine, vinegar, spicy, hot, poor prosthesis, residual crown, and residual roots can also cause white spots. Among systemic factors, Candida albicans infection, iron deficiency anemia, vitamin B12 and folic acid deficiency, syphilis, and radiation, dry mouth, etc. are closely related to white spots. The patients were more middle-aged and older, and more men than women (male: female = 13.5:1).

an examination

Related inspection

Fungal histopathology oral endoscope

1. White keratinized plaques appear on the oral mucosa, but do not include white keratosis that can be resolved after removal by local irritants such as smoking.

2. More common in male smokers of middle age or older.

3. Clinical diagnosis points

(1) Homogeneous type: white plaque, rough surface, wrinkled paper or grooved, grooved.

(2) Heterogeneous type: 1 -shaped type: milky white, thick and high, uneven surface, fluffy or thornlike, rough and hard. 2 granule type: There are keratinized granules or nodules of different sizes on the mucous membrane, which are higher than the mucosal surface and may be accompanied by erosion. 3 ulcer type: there are erosions or ulcers on the white plaque.

4. Biopsy can be seen in the histopathological phase of leukoplakia, the epithelium can be simple keratinization or incomplete keratinization, the granules are obvious, the spinous layer is proliferated in different degrees, and some cases may have epithelial abnormal proliferation. There are varying degrees of chronic inflammation in connective tissue.

5.60 years old or above, the lesion is located in the belly, mouth and mouth of the tongue, with Candida albicans infection, showing sputum, granules, ulcers or erosion type, epithelial abnormal hyperplasia in tissue pathology, conscious irritation or spontaneous pain Should consider the possibility of cancer.

Differential diagnosis

Differential diagnosis of white hard ridges on the oral mucosa:

1. White wrinkle gingivitis: This disease has existed at birth, but it is not obvious. It begins to develop rapidly during puberty and gradually maintains a stable state, but it does not increase with age. Wrinkle gingivitis is a rare autosomal dominant disease that can occur in the nasal cavity, anus, and vulva in addition to the oral mucosa. This disease is also called white sponge-like sputum. The damage is grayish white or milky white, showing a wrinkled, spongy, scaly thick soft tissue. At the time of palpation, these parts still retain the flexibility and elasticity of the mucosa, but they are shaped like a sponge. Buccal mucosal damage is more common, other parts can also suffer, and even affect the entire oral mucosa. Smaller scaly tissue can be removed, and it is painless and reveals a light pink, smooth, non-heavy "surface" similar to normal mucosa. Oral retinoic acid has a significant effect. The white crease gingivitis is seen under the microscope: the squamous epithelium is significantly thickened, even up to 40~50 layers without granules, keratinization is incomplete, the spine cells are swollen, the closer the surface is, the more obvious, the cytoplasm is not stained. The connective tissue has a small amount of inflammatory cell infiltration.

2, Xuekou disease: the age of onset is often small for infants and long-term antibiotics. Acute onset, pain, and white curd-like plaque on the mucous membrane can be removed. The incidence of oral leukoplakia is slow, white plaques can not be avulsed and the age of onset is more than middle age.

3, oral mucosa leukoplakia: oral mucosa leukoplakia referred to oral leukoplakia, is a white plaque that occurs in the oral mucosa, is a precancerous lesion (that is, the possibility of cancer). Oral leukoplakia is the most common and important oral keratosis abnormality. It is an idiopathic, persistent leukoplakia and needs to be diagnosed in combination with histopathology.

4. White keratinized plaques appear on the oral mucosa, but do not include white keratosis that can be resolved after removal by local irritants such as smoking.

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