Leukoplakia is a rare disease of the mucous membranes in Germany, which manifests itself symptomatically by atypical white changes in the affected cell tissue that cannot be wiped off. Due to the high risk of degeneration, leukoplakia should be diagnosed and treated early.
What is leukoplakia?
Normally, leukoplakia does not cause any clear symptoms. The disease is therefore usually discovered during a routine examination by the dentist. See AbbreviationFinder for abbreviations related to Leukoplakia.
Leukoplakia (also known as white callus disease) refers to non-wipeable, white changes in the mucous membrane. The cells in the outermost layer of the mucous membrane become horny and swell due to the moist tissue environment, giving them a white coloration.
Leukoplakia is most common in the area of the oral mucosa, lips, palate and tongue (oral leukoplakia). Leukoplakia is divided into different stages. In the case of homogeneous, simple leukoplakia, the affected tissue areas are regularly discolored and have a smooth, locally well-defined surface.
In contrast, warty (verrucous) leukoplakia has a rough surface, while open (erosive) leukoplakia is characterized by an irregular border and areas of red mucus resulting from injury. The affected cells, especially in the verrucous and erosive form of leukoplakia, have an increased risk of degeneration and can turn into a squamous cell carcinoma (malignant tumor of the skin and mucous membrane).
Leukoplakia is usually due to long-term exogenous stimuli . These stimuli can be of a mechanical or physical nature and can be caused by poorly fitted dentures, brackets and carious teeth.
In addition, leukoplakia can be caused by chemical noxae (disease-causing substances), especially nicotine and alcohol. Poor dental and oral hygiene, a lack of vitamins A and B and iron also promote leukoplakia.
In addition, leukoplakia is associated with genetic diseases such as dyskeratosis congenita (Zinsser-Cole-Engman syndrome) and Darier disease (disease with skin and mucous membrane changes) as well as acquired diseases such as lichen planus (flat lichen planus), the cutaneous form of lupus erythematosus (autoimmune disease) associated.
However, infectious diseases such as tertiary syphilis, HIV or fungal diseases (Candida albicans) can also cause leukoplakia.
Symptoms, Ailments & Signs
Normally, leukoplakia does not cause any clear symptoms. The disease is therefore usually discovered during a routine examination by the dentist. The doctor diagnoses leukoplakia based on the white spots on the mucous membrane that cannot be wiped off. The spots usually appear in large numbers and can be localized in different places on the mouth and lips. The external characteristics provide information about the stage of the disease.
The homogeneous form shows a whitish discoloration that is sharply demarcated. The surface is mostly smooth and regular, but in some cases there are small bumps at the edges. The inhomogeneous forms can be recognized by the rough, wart-like surface. In addition, pain, burning and other symptoms appear in the area of \u200b\u200bthe mucous membrane.
In the case of the erosive subtype, red areas form in the oral cavity, which, on closer inspection, represent injuries to the mucous membrane. Erosive leukoplakia has poorly defined borders and is painful when touched. As the disease progresses, the spots multiply and also spread to the neighboring areas. This is accompanied by the development of a malignant tumor that, if left untreated, can cause further symptoms and complications throughout the body.
Diagnosis & History
Leukoplakia can usually be diagnosed based on the characteristic changes in the mucous membrane. Since leukoplakia does not manifest itself in the majority of cases with any other symptoms, the disease is often discovered by chance during a check-up by the family doctor or dentist.
The diagnosis is confirmed by a sample excision (tissue removal) from the affected region with subsequent microscopic analysis, in which the underlying disease (infection or hereditary disease) can be determined if necessary.
Leukoplakia is easily treatable within the framework of adequate therapeutic measures. However, if left untreated, advanced-stage leukoplakia has an increased risk of degeneration and can develop into squamous cell carcinoma (malignant tumor of the skin and mucous membrane tissue), which is why atypical changes in the area of the mucous membranes should always be examined by a doctor for possible leukoplakia.
As a rule, those affected by leukoplakia suffer from white spots, which mainly appear on the mucous membranes. Aesthetic problems occur primarily on the face, around the mouth and on the lips. It is not uncommon for those affected to no longer feel well and suffer from inferiority complexes and reduced self-esteem.
Furthermore, it can also lead to discomfort or pain in the teeth. In children, leukoplakia can therefore lead to bullying or teasing, which can lead to the development of psychological problems or depression. Furthermore, leukoplakia can also cause a tumor, which can lead to a reduction in the life expectancy of the affected person. The patient’s quality of life is significantly reduced by this complaint.
Treatment of leukoplakia must start early to prevent various complications. Early treatment by the dentist is therefore necessary, especially for children. There are usually no complications and the symptoms can be alleviated relatively well. The patient’s life expectancy is also not affected or reduced if the treatment is successful.
When should you go to the doctor?
If changes to the mucous membrane are noticed, a doctor’s visit is indicated. Whitish, conspicuously hardened areas on the lips or in the mouth indicate a serious illness such as leukoplakia and must therefore be examined. In the case of injuries to the mucous membrane, increasing pain and other symptoms, medical advice is required. People who wear dentures or braces or suffer from tooth decay do not always have to see a doctor for leukoplakia. These types of growths often go away on their own once the condition that caused them has been addressed.
Smokers, alcoholics and generally unhealthy people belong to the risk groups for malignant leukoplakia and should present any symptoms described to a doctor immediately. If the symptoms occur after a bacterial infection or a fungal infection, you should also go to the family doctor. If the tumors degenerate, a doctor’s office should be consulted immediately. Wart-shaped leukoplakia in particular must be closely monitored and, if in doubt, medically clarified. If the mucosal changes recur, the doctor must be informed. The same applies if side effects such as numb spots or pain in the mucous membranes appear some time after recovery. The right doctor is the dentist whodermatologist or an internist.
Treatment & Therapy
The treatment of leukoplakia is primarily aimed at the underlying causes. For example, a poorly fitting denture should be adjusted accordingly by the dentist or decayed teeth should be treated. Any infectious diseases that cause leukoplakia must also be treated.
Leukoplakia often resolves on its own within a few weeks after the causative factors have been eliminated. If this is not the case, the areas of the mucosa affected by leukoplakia are usually surgically removed as part of a minimally invasive procedure. The surgical techniques used here are electro-caustic removal and a cryosurgical procedure.
During electrocaustic ablation, the affected tissue areas are precisely heated and destroyed using a small needle, loop or ball attached to the tip of a low-current device. Although pain can occur postoperatively, which must be treated accordingly, the wound caused by the procedure heals well within one to three weeks. In addition, the tissue areas affected by leukoplakia can be destroyed as part of a cryosurgical intervention through local freezing (physical-destructive method, cryonecrosis) by cooling them down to below -40 C° with liquid nitrogen.
Outlook & Forecast
The prognosis of leukoplakia depends on the underlying cause. In the case of a denture that is not well adjusted, in many cases a corresponding correction can achieve freedom from symptoms. Diseased teeth must also be treated and removed if necessary. Without improving the conditions in the mouth area, the symptoms cannot be alleviated. Medication can be administered to help, but the cause must be clarified in order to achieve permanent freedom from symptoms.
To improve the prognosis, the consumption of pollutants should be completely avoided. In addition, oral hygiene must be optimized and adapted to the needs of the human organism. Otherwise, the prognosis worsens. If the patient has a chronic viral disease, the prognosis worsens. In the case of an infectious disease, long-term therapy is usually necessary, which relieves the symptoms, but has no healing option.
If the cause of the symptoms is due to a fungal disease, recovery can often be achieved. This depends on the disease triggers present and the general state of health of the person concerned. The worse the body’s immune system is, the more difficult it is to treat fungi. If an autoimmune disease is present, the prognosis is also unfavorable. In these patients, treatment is also aimed at relieving symptoms.
Leukoplakia can be prevented by avoiding the triggering factors. Risk factors for leukoplakia include nicotine and alcohol consumption, poor oral hygiene, and poorly fitted dentures and brackets. Since the disease has a comparatively high recurrence rate (recidivism rate), those already affected by leukoplakia should have regular follow-up examinations.
Aftercare for leukoplakia primarily includes preventive measures, especially in view of the high recurrence rate. In addition to careful and increased oral hygiene, this also includes regular visits to the dentist. A healthy lifestyle is also recommended, which goes hand in hand with a balanced diet and the extensive avoidance of alcohol and nicotine consumption. Affected people are well advised to pay more attention to dental care in general, and if necessary, the treating doctor can give appropriate tips and advice to reduce the suffering.
You can do that yourself
In the case of leukoplakia, those affected can take various measures to support medical treatment. In general, the causes of the symptoms must first be determined.
If the leukoplakia is caused by caries, the carious teeth must be extracted. This is a routine procedure, after which those affected are not allowed to eat solid food for a few hours to days. In addition to dental treatment, dental hygiene must be improved in order to reduce the risk of further problems. If the leukoplakia has been triggered by chemical noxae such as nicotine or alcohol, the lifestyle must be changed. The triggering substances must be strictly avoided. In most cases, those affected have to start therapy or turn to a self-help group.
A causal vitamin or iron deficiency is easier to treat. In this case, it is enough to change the diet and supply the body with the necessary substances. If the condition is caused by a serious infectious disease such as HIV, syphilis, or a fungal disease, the most important thing to do is to get it diagnosed and treated promptly. The best way for the patient to support recovery is to follow the doctor’s orders and let the doctor know of any unusual symptoms.