Leukoplakia
Introduction
Introduction to leukoplakia Leukoplakia is a white plaque on the tongue mucosa. It is divided into benign white keratosis and white spots of premalignant lesions according to its malignant tendency. The reason for this is that white keratosis is mostly caused by external factors, and external factors are mainly local institutional, chemical, physical and inflammatory changes. The pre-eclampsia leukoplakia is caused by the quality of the inner individual. The quality of the inner individual is different. Under the same conditions, some people are susceptible to cancer. This internal quality is related to heredity, immunosuppression, low immune function and lack of nutrition such as vitamin A and E. . The white spots of lichen planus are mostly isolated lesions, while lichen planus can be damaged in most mucosa. Lichen planus exhibits multiple forms of damage, and in addition, patients with lichen planus are often accompanied by skin lesions. The leukoplakia is confined to the oral cavity and occasionally appears in other parts of the mucosa without skin damage. basic knowledge The proportion of illness: 0.0005% Susceptible people: no specific population Mode of infection: non-infectious Complications: tongue cancer
Cause
Cause of leukoplakia
Local stimuli (45%)
Local stimuli have a very important role in the pathogenesis of leukoplakia. Smoking is a common cause. People with smoking habits account for 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.
External factors (20%)
White keratosis is mostly caused by external factors, mainly local mechanical, chemical, physical and inflammatory changes. Pre-malignant leukoplakia is caused by the quality of the inner individual. The quality of the inner individual varies from person to person. Under the same conditions, some people are susceptible to cancer.
Systemic factors (30%)
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.
Prevention
Plaque prevention
Follow the doctor's advice, quit smoking and alcohol, remove all irritating factors, combined with appropriate treatment, some leukoplakia can gradually disappear, early detection, early treatment, patients and doctors cooperate with each other, can prevent problems before they occur.
Complication
White spot complication Complications tongue cancer
The disease belongs to the shedding of skin pigments. Due to the change of skin morphology, local resistance is reduced, and it is easy to combine bacterial and fungal infections. For small infants and patients with low immune resistance or long-term use of immunosuppressive agents, infection treatment is not timely. It can be immersed in the blood system, causing sepsis and bacterial encephalopathy. At the same time, the disease also has a certain risk of cancer.
Symptom
Symptoms of leukoplakia Common symptoms Mirrory tongue on both sides of the edge of the hairy leukoplakia pale inflammatory cells infiltrating the tongue root abscess
Histopathological changes of leukoplakia:
1. Epithelial simple hyperplasia is hyperkeratosis or incomplete keratinization of the surface epithelium, obvious granules, hyperplasia of acanthosis cells, large epithelial spikes, different numbers of inflammatory cells infiltrating in connective tissue, no malignant tendency, stimulating factors removed Afterwards, the white spots gradually become thinner and disappear, and the homogeneous white spots belong to this pathological change.
2. Epithelial dysplasia is hyperplasia of epithelium, abnormal keratinization of epithelial cells and atypical hyperplasia and even malignant transformation of cells, such as basal cell polarity change, irregular epithelial stratification, disordered arrangement, increased nuclear division, increased nuclear chromatin, nuclear concentration Dyeing, nucleolar, etc., abnormal hyperplasia epithelium is limited to the intact intradermal basement membrane, which can be regarded as carcinoma in situ, and the basement membrane involvement has been broken. It becomes an early invasive carcinoma, and the sputum, granules and erosion type have a tendency to malignant. Special attention should be paid to follow-up observation.
[clinical manifestations]
White spot on the tongue occurs mostly on the back of the tongue, the abdomen or the tongue. The white spot is clearly defined, slightly above the mucosal surface. The color is milky white, grayish white or yellowish white. The surface of the lesion may be rough or uneven, or have granules. Protrusion, or erosion, can also spread some red areas in the white spots.
According to clinical manifestations, white spots can be divided into four types:
1. Homogeneous (homogeneous leukoplakia) lesions are white plaques, slightly higher than the mucosal surface, slightly rough surface, wrinkled paper, no symptoms, or convulsions.
2. verrucous proliferation (white verrucous proliferation), thick and high, the surface is a ridge-like protrusion, the texture is hard and rough.
3. Granular type is a white granular keratosis which is fine and exuded on the mucosal surface of redness, and resembles fluff.
4. Erosive type There are erosions on the white plaque, which may form ulcers and have obvious pain.
Examine
Examination of leukoplakia
The white spots of lichen planus are mostly isolated lesions, while lichen planus can be damaged in most mucosa. Lichen planus exhibits multiple forms of damage, and in addition, patients with lichen planus are often accompanied by skin lesions. The leukoplakia is confined to the oral cavity and occasionally appears in other parts of the mucosa without skin damage.
Combined with clinical routine oral examination, if necessary, do tissue biopsy to confirm the diagnosis.
Diagnosis
Diagnosis of leukoplakia
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
Identification with lichen planus:
White spots are mostly isolated lesions, while lichen planus can be damaged in most mucosa. Lichen planus exhibits various shapes of damage such as white plaques, reticular lesions, blister damage, erosion and red and white damage, in addition, flat Moss patients are often accompanied by skin lesions, white shifts are limited to the oral cavity, occasionally in other parts of the mucosa, without skin damage, for the case of unclear identification, a correct diagnosis can be obtained by histological examination.
