Leukoplakia of the oral cavity: a stone's throw from cancer

Leukoplakia of the oral cavity - this is how the Latin name of one of the forms of benignly degenerated mucous membrane sounds, under the influence of certain factors, changing its structure, structure and properties.

And these factors for the existence and development of leukoplakia should act continuously for a sufficiently long time.

If the effect is stopped( due to accidental or as a result of purposeful action), the mucosa can fully recover independently and without special measures.

With the continuation of the harmful effects of tissue degeneration is irreversible - formed cancer.

Development mechanism

Different types of leukoplakia are inherent in certain ages, mainly disorders are observed in middle and advanced agepeople, more often - in men.

Modified areas covered with a multilayer cover cloth - epithelium. In places where it is homogeneous, it occurs rarely and under especially unfavorable conditions. But wherever one tissue passes into another - much more often.

This is the area of ​​skin-mucosal transition( on the lips), or those where the mucous membrane of one structure passes into the mucosa of another structure. The process, having begun, either stabilizes, or slowly gains in strength.

In the mouth and in the language

A special case of the phenomenon is leukoplakia in the oral cavity. Proceeding from the above, we can assume the most probable places of its detection, those where the following conditions exist for the development of the violation:

1. . The folds between the lips and jaws are slow-moving and difficult to access "relief depressions", so cozy "deaf closets"where food remains and products of destruction of own tissues are most easily accumulated and decomposed.
2. This includes places, the most "loaded with work" ( transition between a hard and soft palate).
3. Areas often damaged by , such as the transition of the tongue back to its lateral areas, or often the teeth injured by the internal surfaces of the cheeks.

Special conditions and separate provocative states

In addition to injuries( biting of lips, cheeks, tongue, damage to the gums with faulty prostheses, braces) and a large mechanical load, in addition to infection and decomposition of food residues( creating an acidic environment in the mouth), there are also leukoplakiaother factors:

1. These are the specific negative addictions food( in the form of spicy and fried, too hot or cold food) and drinking ( in the form of alcohol).
2. Either it can be tobacco smoking, regular UV irradiation, or unfavorable working conditions ( penetrating into the oral cavity when breathing carcinogens, as well as vapors of gasoline, resins, dyes and varnishes).
3. The influence of such minor processes as galvanic currents flowing between the teeth crowns from dissimilar metals.
4. It is also possible the depressing mucosa the action of various groups of medicines , especially - taken in large quantities.
5. Separate attention deserves chronic exhausting diseases : GASTROINTESTINAL TRACT, endocrine, deficient states( hypovitaminosis and anemia), HIV infection, special periods in life( climacteric and puberty).
6. You should not discard the genetic predisposition from the accounts and , and the basic lack of hygiene skills.

The mucous membrane, protected from unfavorable conditions of life, hardens, compacts, keratinizes, is covered with a protective "bark" that insulates the underlying layers of tissue. Conditions change - there is no longer any need for protection.

Morphology of the disease

There are such types of leukoplakia:

• flat( hairy);
• leukoplakia smokers;
• is uterus;
• is erosive.

What does the leukoplakia of the simplest structure look like?

This is a zone of more or less intensive keratinization, from a full-fledged field of the mucous membrane sharply delimited, with uniformly continuous haze( dry and somewhat rough).

The color of the hearth from different shades of gray to white without a condensed base resembling a film depends on the thickness of the stratum corneum, the contours of the lesion are toothed-scalloped.

With the formation of the mobile-stretchable( on the inner surfaces of the cheeks) or collected in the folds( the bottom of the mouth), the focus of hairy leukoplakia is a wrinkled or folded film.

If the corners of the mouth are affected, the outbreak at the periphery can be delineated by a line of hyperemia.

In the photo, hairy leukoplakia of the oral cavity

Verrux and erosive forms of violation

The structure of leukoplakia is somewhat more complicated, because in translation from the Corsican dialect verrucosa means: warty.

The lesion focus either rises 2-3 mm above the surface of the mucous membrane in the form of a smooth white-white plaque( like an iceberg frozen in the ice of flat leukoplakia, not protruding at the level of the mucous membrane), or looks dirty white warty, not too denseconsistency of education.

When the surface of the verrucose or flat leukoplakia is eroded( or dissected at different depths by cracks), the process passes into the phase of leukoplakia erosive.

The cornification of the palate is both hard and soft, having a solid character and color whitish gray with red dots of stomata of inflamed and yawning ducts of salivary glands( and with a far gone process - with the formation of nodular structures with a red dot on the top of each nodule), in humansactively smokers called leukoplakia Tappeynera, or smokers.

Pashkov's disease

Soft leukoplakia( Pashkova), existing in two versions: in the form of leukoedema( atypical form with a smooth surface of the mucous membrane) or in the form of "cheek biting"( a typical shape with a rough surface).

The disease is inherent in children and young( up to 30 years) women with unsteady psyche, is a consequence of the habit of biting lips, cheeks, tongue, mechanically pressing the finger of the cheek or lip between the teeth in a situation that causes nervousness.

The scar tissue formed due to such traumas on the inner surface of the cheeks, tongue and lips is automatically mechanically dented by the teeth.

The two forms of the disease are distinguished:

1. In the typical form on the inner surface of the cheeks, lips, tongue on the closing line of the teeth, the mucosal pattern resembles the moth-eaten tissue or curly "washcloth" with fringe-loosened epithelium of uneven length, which can be partially removedscraping by spatula. In far-reaching cases, due to the skewing of the epithelium with a significant depth of damage, erosion causing painful sensations is formed in these places.
2. When atypical form , soft leukoplakia is a diffuse cloudiness in a limited area of ​​the mucous membrane of the cheeks( or lips) in the form of an opalescent band rising above the mucosal layer on the dentition line, without a scrappy pattern and flaking. Red lip rim atypical form of the disorder is usually not damaged.

Symptomatic

Sensations of leukoplakia are usually not pronounced and depend on the depth of mucosal damage.

In most cases, complaints are not presented at all, or they are limited by the roughness of the mucous membranes, the feeling of "tightness", with the involvement of the language process, a decrease in taste sensitivity is possible. This is the case with most types of disturbance.

Depending on the type of leukoplakia, the following signs can also be expressed:

1. With soft , a sensation of discomfort from a thickened, edematic, but painless tissue is added to the described manifestations, which patients simply bite their teeth. Sensitivity of taste and temperature( depending on the extent of the damage) can be reduced.
2. Veracious can cause varying degrees of painful manifestations, the nature of which depends on the properties of the food: itching, burning.
3. Erosive delivers significant pain at any time of day.

Diagnostic signs

For diagnosis( difficulties not usually present) in this condition, the following is used:

• visual inspection, history collection, observation of the patient's behavior;
• cytological, histological and microbiological examination of tissues;
• electron microscopy;
• method of optical coherence tomography.

To differentiate soft leukoplakia from red flat lichen and candidiasis make scraping from the oral mucosa.

To clarify the diagnosis for this pathology also allows the study of luminescent emission after ultraviolet irradiation of damaged tissue( photo diagnosticoscopy).

Aims and methods of treatment

The goal of the treatment for oral leukoplakia is:

• elimination of the cause and getting the patient out of the cancer-related condition;
• general improvement of the body;
• restoration of the integrity of damaged tissues.

Conservative methods of treatment include sanitation of the oral cavity, including grinding the sharp edges of teeth and prostheses.

If necessary, the replacement of prostheses, treatment and filling of carious teeth as a focus of infection.

Vitamin A is mandatory, both for oral administration within 1-2 months, and for local applications.

The use of complexes including vitamins C, B3, B6, coral calcium, accelerating the healing process of coenzyme Q10 and green tea extracts contributes to the successful recovery of the patient's health.

For the treatment of cracks and wounds with erosive and verruzed forms of leukoplakia, and for the restoration of damaged red lip rims, photoprotective and regenerating agents are used.

More details about the treatment and causes of leukoplakia in Elena Malysheva's program:

What complications can be expected?

The possibility of malignant degeneration of the oral mucosa is one of the complications in the transition of leukoplakia flat to erizable and erosive.

Therefore, continuous monitoring of the condition of the pathological focus is necessary.

Prevention of development pathology

For the purpose of prevention it is necessary to instill hygienic skills from childhood, teaching the child techniques for careful oral care, teeth, braces and dentures. If necessary, their adjustment and replacement, restoration of normal bite.

Fighting infection in the mouth and overcoming bad habits( smoking, alcoholism) is an obligatory aspect of preventing pathology.

Psychotherapeutic help is provided to children, as well as a category of patients at risk of developing soft leukoplakia.