Pathology: Oral Leukoplakias and Erythroplakia
What is the most common cause of oral leukoplakia?
Tobacco smoking is the most common cause of oral leukoplakia. More than 80% of leukoplakia patients are smokers.
What is the relationship of actinic cheilitis and cancer?
Ultraviolet radiation from sun exposure can result in the degeneration of the tissue of the lips. Leukoplakia of the lip vermilion (usually lower lip) is commonly a component of actinic cheilitis. There is an extremely strong association between vermilion leukoplakia and vermilion carcinoma.
Can we say that Candida albicans causes leukoplakia?
We cannot say that Candida albicans causes leukoplakia, although the fungus is often found in severe, thickened cases of leukoplakia. It is not known whether it produces dysplasia or secondarily infects previously altered epithelium, but the fungus is seldom found in mild cases. Candida leukoplakias disappear or become altered to a lower phase level after topical antifungal therapy.
Does friction or trauma produce precancerous changes?
No. Lesions caused by friction or trauma have never been reported to have transformed into malignancies.
Is leukoplakia more prevalent among males or females?
Leukoplakia is more prevalent in males, especially in the oldest age groups. 70 – 80% of all cases are males, with prevalence increasing from less than 2% in 20 year old males to more than 8% in males aged over 75 years of age. The average age of affected persons is 60 years old.
What is the average rate of transformation of leukoplakia to cancer? What is the range?
The average rate of transformation of leukoplakia to cancer is 4 to 6%, and ranging from 1 to 28%.
The malignant transformation potential of an individual leukoplakia depends on variables such as: gender, habits, location of lesion and clinical appearance of lesion.
What is the likelihood that a person with erythroplakia is a tobacco smoker?
Over 94% of affected patients smoke tobacco (and more than 65% abuse alcohol).
Why are erythroplakias considered more dangerous than leukoplakias?
The average rate of malignant transformation of leukoplakias is 4 – 6%.
Microscopic examination of erythroplakias reveals severe epithelial dysplasia or carcinoma in situ.
Severe epithelial dysplasia has been shown to proceed to malignant transformation in at least 1/3 of all cases.
