Leukoplakia And Hyperkeratosis

Hyperkeratosis refers to increase in kertin layers.It occurs when there is definite aetiological causes and it is reversible.

E.g. Smokers hyperkaratosis of the palate and lips. Once the aetiological agent is withdrawn ,the lesion returns back to normal.

Leukoplakia appears clinically as a white patch in the mouth and cannot be scraped off.It is irreversible and occurs due to various aetiological factors.

Common causes of leukoplakia

• Smoking results in hyperkeratosis. Nicotine in the form of cigarettes,chewing tobacco,powdered snuff produces premalignant changes in the oral cavity.
• Spices
• Spirits have synergistic action with smoking.
• Sharp tooth,sepsis,poor oral hygiene.
• Sunlight-Actinic rays
• Syphilis causes endartiritis obliterans and results in chronic superficial glossitis of the tongue which is precancerous conditions(Rare now a days)
• Susceptibility of a person.

Betel nut,slake lime with betel leaf and tobacco(Pan) is eaten and usually kept inside the cheek for many hours.Overs the years,it brings about chronic irritation of mucosa of the cheek and causes leukoplakia.Tobacco contains multiple carcinogens including aromatic hydrocarbons.

Stages in the development of leukoplakia:

1. Keratosis appears as milky blush on the surface.
2. Acanthosis refers to elongation of rete pegs.This apears as a smooth,white,dry patch.
3. Dyskeratosis means the formation of keratin cells/layers in the deeper aspect of epidermis,before they reach the surface.
4. Speckled leukoplakia appear as multiple,small white patches.
5. Carcinoma in situ.

Erythroplakia is a red lesion with more incidence of malignancy.

TREATMENT OF LUEKOPLAKIA:

• About 10% of leukoplakia patients develop oral cancer.Hence,superficial excision of the lesion followed by skin grafting should be done.