Leukoplakia is a precancerous mucous membrane condition -- manifested by white patches -- that develops on the tongue, gums, or the inside of the cheek. Occasionally, patches develop on the female external genitalia. This condition is most common in older men.
Oral leukoplakia treatment
This condition is usually treated by removing the source of the
irritation, for instance stopping tobacco chewing, smoking or correcting
dental problems. Leukoplakia patches can be removed by a dentist or oral
surgeon using a scalpel, laser or cryoprobe, an extremely cold probe that
freezes and destroys cancer cells.
There is an exciting possibility that retinoids —
derivatives of vitamin A that are used to treat severe acne and other skin
conditions — may be helpful for oral leukoplakia. Natural
carotenoids such as beta-carotene, an antioxidant that's converted to
vitamin A in your body, may also completely or partially reduce
leukoplakic patches. Recent studies indicate that
lycopene may be helpful.
Lycopene is a carotenoid with a pink/red color found in tomatoes,
watermelon, and other fruits. Lycopene is available as a supplement.
Perhaps curcumin
and other herbs that fight
cancer could also
play a role.
Curcumin therapy
Cancer Prev Res (Phila). 2016. A Randomized Double-Blind Placebo-Controlled
Phase IIB Trial of Curcumin in Oral Leukoplakia. We investigated the
effectiveness of curcumin, a potent inhibitor of NF-κB/COX-2, molecules
perturbed in oral carcinogenesis, to treat leukoplakia. Subjects with oral
leukoplakia were randomized to receive orally, either 3.6 g/day of curcumin or
placebo, for 6 months. Clinical response was observed in 67% subjects in the
curcumin and 55% in placebo arm. Continued therapy, in subjects with partial
response at 6 months, did not yield additional benefit. The treatment did not
raise any safety concerns. Treatment of oral leukoplakia with curcumin (3.6 g
for six months), thus was well tolerated and demonstrated significant and
durable clinical response for 6 months.
Efficacy of oral lycopene in the treatment of oral leukoplakia.
Oral Oncology. 2004.
This study evaluates the efficacy of lycopene in the treatment of oral
leukoplakia and compares two different doses with a placebo. Fifty-eight
clinically and histologically diagnosed patients of oral leukoplakia were
selected for the study. They were randomly divided into three groups. Group A:
(8 mg lycopene / day), Group B: (4 mg lycopene / day) and Group C
(placebo). The duration of the therapy was three months. Outcome was
assessed clinically as well as histologically. Post-treatment patients were on
follow-up for two months. Student's 't' test was used for statistical
evaluation. Clinically the patients in Groups A, B, C had a mean response of
80%, 66% and 12% respectively. Histological evaluation too had similar
results. Patients receiving lycopene in both regimes show highly significant
difference in response as compared to placebo (Group C). The observed effect of
lycopene suggests that it can be effectively and safely used for the management
of oral leukoplakia.
Cause of oral leukoplakia
This condition may develop as a response to chronic irritation, for
instance dentures, or from smoking or alcohol abuse.
SADJ. 2012. Leukoplakia and erythroplakia of the oral mucosa--a brief overview. Leukoplakia and erythroplakia are the two most common potentially malignant disorders of the oral cavity. The prognosis and overall survival of a patient with oral cancer is dependent on the early detection of any lesion that might identify a patient with higher risk than normal or with early infiltration before metastatic disease. The role of the general dentist cannot be overstressed and the aim of this brief summary is to give the general practitioner an overview on the current concepts relating to these disorders. Leukoplakia and erythroplakia were traditionally known as two "precancerous lesions of the oral mucosa". The term "precancer" defines all lesions classified as such to have a "precancerous nature" implying that all of them will eventually become malignant. Through the years it became known that even clinically normal mucosa may show features of dysplasia and in some instances molecular aberrations of early malignant transformation may be found in the mucosa of a patient without any clinical lesions or dysplasia. The consensus view then was to introduce the term: "potentially malignant disorders" (PMD) reflecting the more generalised mucosal involvement in these patients.
Hairy leukoplakia
information
Oral hairy leukoplakia is a white thickening or coating of the
lining of the mouth. It looks like white vertical folds or ridges. These
ridges are almost always located on the sides of the tongue. Hairy
leukoplakia is often a sign of HIV infection and an increased likelihood
of developing AIDS. Oral hairy leukoplakia is often one of the first
opportunistic infections to occur in HIV-positive people. It can occur
at any T-cell count, but it is most common among HIV-positive people
with fewer than 300 T-cells. It is also important to note that it can occur in people with healthy immune systems, including
those not infected with HIV, such as organ transplant recipients.
Hairy leukoplakia is a condition now thought to
be caused by the Epstein-Barr virus (EBV), a member of the herpes virus
family which is commonly found in the mouth.
Oral Leukoplakia Research
Although leukoplakia responds to some treatments relapses and adverse
effects are common.
Evid Based Dentinstry. 2005.
The Cochrane Oral Health Group's Trials Register, Cochrane
Central Trials Register, Medline and Embase were searched, as well as the
following journals: Cancer, Community Dentistry and Oral Epidemiology, European
Journal of Oral Sciences, Journal of Dental Research, Oral Oncology, Oral
Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics. The
reference lists of included studies and reviews were checked, and oral medicine
experts were contacted through a European mailing list (EURORALMED). Randomised controlled trials (RCT) were included if they had enrolled
patients who had a diagnosis of oral leukoplakia and who were undergoing any
surgical or medical (topical and systemic) treatment. The primary outcome
considered was malignant transformation of leukoplakia demonstrated by
histopathological examination. Other outcomes considered were clinical
resolution, histological modification and frequency of adverse effects. Data were collected using a specific extraction form.
The validity of studies included was assessed by two reviewers, on the basis of
the method of allocation concealment, blindness of the study and loss of
participants. Data were analysed by calculating relative risk (RR).
The possible effectiveness of surgical interventions, including laser
therapy and cryotherapy, has never been studied by means of an RCT. Nineteen RCT
of nonsurgical interventions were identified: seven were included. Vitamin A and
retinoids were tested in five RCT (245 patients); the other drugs tested were
bleomycin (one study), mixed tea (one study) and beta-carotene (one study).
Malignant transformation was recorded in just two studies. None of the
treatments tested showed a benefit compared with placebo. Treatment with
beta-carotene and vitamin A or retinoids was associated with significant rates
of clinical resolution, compared with placebo or absence of treatment. Whenever
reported, a high rate of relapse was a common finding. Side effects of variable
severity were often described but interventions were well accepted by patients,
since dropout rates were similar between treatment and control. To
date there is no evidence of effective treatment in preventing malignant
transformation of leukoplakia. Treatments may be effective in the resolution of
lesions, but relapses and adverse effects are common.