Leukoplakia (also: leukokeratosis, white callosity) is a disease in which the cornea of the mucous membranes (especially in the oral area) is thickened and therefore white, unwipeable streaks form in these areas. The risk of such a skin change developing into a malignant skin tumor (squamous cell carcinoma) is increased compared to normal (mucous) skin. In Germany, about one in 100 people suffer from leukoplakia, with men being affected about twice as often as women.
The disease occurs most frequently in middle to old age. Leukoplakia can occur when the mucous membrane is subject to chronic irritation. This causes a thickening of the horny layer.
As a result, the blood vessels lying just below the surface can no longer protrude as clearly in such a case, which is why the mucous membrane appears whitish instead of red at this point. The chronic irritation can have various causes: In addition, there are certain factors that favour the development of leukoplakia:
- Chemical stimuli (cigarette or pipe smoking)
- Biological stimuli (viral infections, which mainly affect the mucous membrane of the genital area)
- Mechanical stimuli (badly fitting dentures)
- Iron Deficiency
- Deficiency of vitamin A and vitamin B
- Excessive consumption of alcohol
- Poor oral hygiene
Apart from the typical appearance with whitish, sharply defined, non-detachable mucous membrane changes, leukoplakia is usually not accompanied by any other symptoms. In contrast to many other skin diseases, pain and itching do not occur in this disease.
Mostly the mucous membranes of the mouth, tongue and lips are affected, more rarely also the mucous membrane of the genital area. Depending on the appearance of the skin symptoms, two subforms of leukoplakia can be distinguished:
- Homogeneous form (also known as simple or non-proliferative form) in which the discoloration is regular and the skin surface is smooth.
- Inhomogeneous form (also known as warty or proliferative form) is characterized by the fact that red spots can occur in the white areas and the surface is of a warty, rough texture. Typically, at this stage, the limitation compared to healthy skin is also not as clear.
In contrast to the homogeneous form, the inhomogeneous form of leukoplakia has a higher risk of degeneration and more frequent symptoms such as pain or burning.
The diagnosis of leukoplakia is usually made by chance during routine examinations by a doctor or dentist, as the disease does not cause the patient any discomfort. To confirm the diagnosis, it is advisable to take a tissue sample from the affected area and to examine it histologically. Important differential diagnoses of leukoplakia are
- Various infections (e.g. by the fungus Candida albicans or the Epstein-Barr virus)
- Hair leukoplakia, which can occur in the context of HIV
- Lichen ruber
First of all, it is important to consistently avoid the triggering factor of leukoplakia as far as possible.
Patients should therefore stop smoking under all circumstances, optimize the fit of their dentures or treat an existing viral infection adequately. If this behavior is strictly adhered to, there is a very high chance that the leukoplakia will heal itself within a few weeks. However, if the skin changes have still not receded after some time (in about 20% of those affected), it is important to carry out treatment, as there is a possibility that a longer-standing leukoplakia may turn into a malignant tumor.
Therefore, persistent (permanently present) foci are usually removed. This can be done with the help of one. Complete ablation (excision) is normally the preferred method, since here the edge of the tissue can be checked afterwards to see whether the skin change could be completely removed and whether malignant degeneration has already occurred.
- Ablation
- Icing of the horn cells (cryosurgery) or
- Laser Removal
The prognosis of a simple leukoplakia is considered very good. If the triggering factor can be identified and consistently eliminated, it almost always regresses by itself. In addition, the risk of degeneration in this form must be classified as extremely low (less than 3%).In inhomogeneous, wart-shaped leukoplakia, there is a slightly higher risk that it will eventually develop into a malignant tumor.
Especially if it is advanced and so-called erosions (red spots) have already formed, the risk of degeneration increases up to 30%. Therefore, if you suspect such a disease, you should definitely consult a doctor. If the leukoplakia is discovered in time, it can be treated well.
However, many patients often relapse into leukoplakia. It is therefore important to visit your doctor at regular intervals for check-ups so that any recurring changes can be detected and treated early on. In order to prevent leukoplakia, you can do a lot yourself.
It is extremely sensible to avoid common risk factors such as cigarettes, pipe smoking and alcohol. In addition, you should ensure that you have appropriate oral hygiene and that a dental prosthesis fits well and firmly in the mouth. Finally, it is of course important to have regular routine check-ups with your doctor and dentist and to consult a doctor even if the mucous membrane changes are unclear and do not recede by themselves, so that leukoplakia can be ruled out.
Skin changes such as the formation of wrinkles are a natural phenomenon of aging. Other changes in the skin, in turn, can be an expression of a disease of the skin or other organs. Here you will find the topic: Skin changesOral hygiene includes the care of the teeth and mucous membranes of the mouth and tongue. In addition to brushing your teeth, there are other ways to ensure good oral hygiene. Here you will get to the topic: Oral hygiene
