Erythroplakia: Description, Causes and Risk Factors: ErythroplakiaErythroplakia is a red patch which is usually flat or a swelling in the mouth area that cannot be associated to other pathology. Erythroplakia is an uncommon and subtly innocuous change of the oral mucosa, but it has very specific and identifiable clinical characteristics, therapies, and prognostic features. It is the most dangerous of all the oral cancer precursor lesions, and a search for erythroplakia should be a part of every oral soft tissue examination in persons aged 35 years and older. No erythroplakia lesions should ever be left untreated. Much has been written about the malignant potential of oral leukoplakia, but too often the dental profession has ignored the more dangerous discoloration, erythroplakia, which carries a much greater cancer risk than the white lesions. A clear understanding of this lesion may save lives by identifying oral cancers prior to invasion or at an early stage, thereby avoiding extensive surgery and spread of the disease to other parts of the body. There are many various conditions which appear similar. This conditions must be ruled out (include or exclude by determining judicially or in agreement with rules) and distinguished from erythroplakia before a certained diagnosis of the condition can be made. There are times that a diagnosis is up to be delayed for long periods up to two weeks so that or to see if the swell or the lesion is spontaneously regressing or if there is another cause that can be found. Erythroplakia usually is associated to dysplasia. Erythroplakia can be classified into the following types: • Homogenous. • Erythroplakia interspersed with the leukoplakia patches. • Granular or speckled. The exact causes for the formation of erythroplakia is unknown, but researches presume that, it should be resulting from the same causes as squamous cell carcinoma (a cell disorder). Erythroplakia is frequently associated with dysplasia (abnormal cell disorder), so it also a precancerous lesion. Other potential risks of erythroplakia include • Excessive alcohol consumption. • Smoking or exposure to chewing tobacco carcinogens. • Long term irritation from dentures or rubbing teeth. • Poor general health due to deficiency in vitamins A, C, B12 and folic acid. • Human papillomavirus (HPV). • A secondary infection or the super infection with candidiasis which might be associated with the dysplastic oral mucosal cells. Often candida albicans has been demonstrated in the erythroleukoplakia lesions and white component and/or the red component of these lesions disappears and diminishes after antifungal therapy, at least in some cases. Symptoms: Symptoms may include the following: • Patches inside your mouth or on your lips that are white, a mixture of red and white, or red. • Mixed red and white patches (erythroleukoplakia) are more likely than white patches to become malignant. • Red patches (erythoplakia) are brightly colored, smooth areas that often become malignant. • A sore on your lip or in your mouth that would not heal. • Bleeding in your mouth. • Loose teeth. • Difficulty or pain when swallowing. • Difficulty wearing dentures. • A lump in your neck. • An earache. • A change in the way your teeth fit together. Diagnosis: Examination and check up of the area can determine the appearance of the swell. Laboratory tests are also done to differentiate it from any other condition which may appear simlar to erythroplakia. Many other conditions may appear as the causes for erythroplakia, so these conditions should be ruled out before making any diagnosis on erythroplakia. In some cases, diagnosis can be delayed for two weeks to see if there is any other cause for the problem or if the lesion can regress on its own. Treatment: Treatment of erythroplakia will mostly involve biopsy of the swell or the lesion to determine the extent of the dysplasia (abnormal tissue development). A surgical intervention via a complete excision of the swell or the lesion is also advised at some cases depending mostly on the histopathology found in the result of the biopsy. However, recurrence or regrowth of the erythroplakia, even in rare cases, is very common. Long-term monitoring of the condition is often required and needed. NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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