What are the other Names for this Condition? (Also known as/Synonyms)

• Idiopathic White Patch
• Leucoplakia
• Leukokeratosis

What is Leukoplakia? (Definition/Background Information)

• Leukoplakia may be described as a benign or pre-malignant condition manifesting as white patches on mucosal surfaces of the mouth (most commonly), esophagus, external genitalia, urinary tract, or anal canal
• It may arise from a variety of factors; smoking is a main risk factor for oral Leukoplakia. Other causes include fungal infection, repeat trauma, vitamin deficiency, and poor immunity. Recognizing Leukoplakia early is important towards averting potential malignancy into the future
• A treatment of Leukoplakia is dependent on treating the underlying causative factor. Individuals with benign white patches may have better prognosis than those with premalignant lesions

Who gets Leukoplakia? (Age and Sex Distribution)

• The presentation of symptoms of Leukoplakia may be noted in both children and adults. However, most cases are observed after the age of 30 years
• Both males and females may be affected
• Worldwide, individuals of all racial and ethnic groups may be affected. It is a fairly common condition with a prevalence rate between 1-5% of the world population

What are the Risk Factors for Leukoplakia? (Predisposing Factors)

The risk factors for Leukoplakia may include a wide variety of factors such as:

• Alcohol abuse
• Allergic stomatitis from various causes, including vaping
• Betel nut chewing; chewing of tobacco
• Candidiasis
• Carcinoma in situ of mucosal surfaces
• Chronic smoking resulting in nicotine stomatitis
• Cutaneous lupus erythematosus (CLE)
• Epstein-Barr virus (EBV) infection
• Frictional keratosis
• HIV infection and AIDS
• Human papillomavirus (HPV) infection
• Oral cavity lichen planus
• Sanguinaria - use of oral toothpaste (herbal) extract containing the same
• Trauma such as from a poorly-fitting dentures, broken tooth, misaligned teeth, or lip/cheek biting
• Vitamin and iron deficiencies
• Weakened immune system

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Leukoplakia? (Etiology)

• In a majority of cases, Leukoplakia develops from an underlying cause. In case the underlying cause is unknown, it is termed Idiopathic Leukoplakia.
• Leukoplakia is not termed as a disease or disorder, but rather as a reactive development to an underlying causative factor that may include chronic trauma, infections, alcoholism, and mucosal malignancies

What are the Signs and Symptoms of Leukoplakia?

The size, location, and appearance of Leukoplakia may depend on the underlying causative condition. The signs and symptoms may include:

• A white plaque/patch on the mucus membranes that cannot be scraped off
• This may affect the mouth (tongue, gums, or inner cheeks), anus, genitals, urinary tract, or gastrointestinal tract. The specific signs and symptoms manifested may depend on the location of the lesion
• The patch may remain unchanged for a long period
• The patches may turn into fluid-filled blisters, which may rupture on trauma and ooze pus
• Dryness and rough surfaces may be noted

How is Leukoplakia Diagnosed?

Leukoplakia is diagnosed on the basis of the following information:

• A thorough physical examination and a complete personal and family medical history
• Laboratory tests and imaging studies as necessary, to detect the underlying cause
• Tissue biopsy: A tissue biopsy of the lesion is performed and sent to a laboratory for a pathological examination, who examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. A tissue biopsy is often necessary to establish a diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Leukoplakia?

The complications of Leukoplakia may include:

• Emotional stress
• Development of cancer
• Recurrences are observed if the underlying cause is not suitably addressed
• Complications of the underlying causative condition, if any present

Complications may occur with or without treatment, and in some cases, due to treatment also.

How is Leukoplakia Treated?

The treatment for Leukoplakia is strongly dependent on managing or treating the underlying cause. However, based on cause and the biopsy results, the healthcare provider may recommend the following:

• Surgical excision of the lesion, especially if early cancer signs are noted
• Laser therapy to destroy the lesion
• Use of freezing temperatures to destroy cells in the plaque (cryotherapy)

Regular medical screening at periodic intervals with tests and physical examinations are recommended.

How can Leukoplakia be Prevented?

• The prevention of Leukoplakia involves avoiding the predisposing factors, such as smoking, repeat trauma, or alcoholism
• Getting appropriate treatment for any underlying medical condition/infection is important

What is the Prognosis of Leukoplakia (Outcomes/Resolutions)

The prognosis of Leukoplakia is dependent upon the nature of the underlying cause and its severity. Typically, the prognosis may be assessed on a case-by-case basis.

• The mucosal lesions may be cancerous in a small percentage of individuals. In such cases, a prompt recognition of the condition and early treatment can result in improved outcomes
• However, it is important to note that a removal of the Leukoplakia patches alone does not ensure decreased risk for cancer development. It is important to suitably address the underlying cause too

Additional and Relevant Useful Information for Leukoplakia:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/