Leukoplakia

leukoplakiaLeukoplakia is a chronic inflammation of the mucous membrane with keratinization of the epithelium in the form of white spots observed on the mucous membranes of the oral cavity (tongue, cheeks, and the lower lip), cervix, vagina, bladder, the penis.
Spot leukoplakia flat, smooth, formed as a plaque whitish-grey, not removable by poskablivanii; leukoplakia may appear as whitish plaques with warty orogovevshie enlargement at the surface - this form is called lejkokeratoz. Foci of leukoplakia are multiple, their color is not always uniform - places whitish-pink, sometimes grayish-white with nacreous tint. Patches can be merged with each other, forming intricate shapes. Subjective sensations often missing, and patients usually find leukoplaxia only at survey of the mucosa. Causes of leukoplakia of the mucous membrane of the mouth - long irritation tobacco smoke, which contains tar, nicotine, phenolic products and others, alcohol and other chemical irritants; repeated trauma carious teeth or ill-fitting dentures. Leukoplakia of the mucous membranes of the oral cavity is usually observed among people over the age of 30-40 years, most men.
Leukoplakia cervical cancer develops in menopause usually as a result of chronic inflammation of the mucous membrane of the cervix, when prolapsed uterus, during avitaminosis a, and sometimes observed in newborns. Leukoplakia of the cervix has a long course, do not respond to antibiotic treatment and requires surgical intervention.
Leukoplakia of the bladder and urinary tract is less common (see bladder, leukoplakia).
Leukoplakia is a precancerous condition (especially lejkokeratoz). Cancer on the background of leukoplakia occurs in about 15-20% of cases. The loss of brightness white spots, the emergence of roughness, defined by the finger, or the detection of skin growths on the spot, as well as the sores should always call suspected malignant transformation.
Treatment and prevention of leukoplakia - primarily the elimination of all causes of constant irritation of mucous membranes. For treatment should never be used cauterizing funds. At detection of leukoplakia patients should be directed to the doctor. It is advisable to appoint vitamins a and C. In the absence of success recommended surgical treatment (electrocoagulation). If cracks, excessive keratinization, seals hearth of leukoplakia, you should perform a biopsy. Patients with leukoplakia should be under medical control, respectively, disease, dentist, gynecologist or urologist.

Leukoplakia (leukoplakia; from the Greek. leukos - white and plakion - tile, vinyl) - opalescent or milky white patches on the mucous membranes next to the skin, such as lower lip, and mucous membranes of the cheeks, tongue (Fig. 1), floor of the mouth, clitoris, cervix, on the mucous membrane of the renal pelvis, bladder and urethra, on the foreskin, when course vulva, etc. the size of the spots is 0.5 cm and more. Leukoplakia belongs to the group of karatoprakliev. Leukoplakia is clear boundaries, rising above the level of the mucosa occurs in two forms: simple and warty - lejkokeratoz (Fig. 2).
The emergence of this polietiologic diseases contribute Smoking, the defeat teeth, poor dental prostheses, excessive use of alcohol, spices, cold or hot foods, vitamin a or complex, inflammatory processes of the oral cavity, metal bridges, fillings, crowns.
Simple leukoplakia (L. simplex). The folds of mucous membrane flatten the surface resembles a tile or parquet, the lesion may spread to a large surface area. Remove white spots by scraping or friction fails, forceful intervention is accompanied superficial bleeding.
Appears when a simple leukoplakia cracks or sores are painful, long not healing, prone to relapses and represent the ground for the emergence of cancer.
Warty L. (L. verrucosa). The level of the mucous membrane raised by a few millimeters. The color of the affected area varies from mother-of-pearl-white to color chalk. In this form of L. patients often complain of a feeling of fossilization, burning, crawling, the violation of taste and pronounced pain, especially tongue and lips. Fast thickening hilly area of leukoplakia or appearance papillomatosic growths, cracks, sores can be a symptom of cancer of transformation that occurs more often, than at simple L.
Histopathology. When leukoplakia, as a rule, there keratinization of epithelial mucous membranes. Keratinization has a pathological character (type parakeratosis). The epithelium, covered orogovevshi layer, significantly thickened; granular layer is expanding; the processes of the epithelium penetrate to different depths; later the basal layer of the epithelium is loosened; border epithelial and connective tissue becomes vague; in the connective tissue see infiltrate composed of fibroblasts, lymphocytes, at least from the plasma cells. On the surface warty L. formation of V-shaped grooves, filled Horny mass. L. sometimes malignities.
Senile keratoma, cutaneous horn, the keratoakantoma histological signs of initial cancer is often detected in the form of leukoplakia.
Treatment. In simple leukoplakia without signs of further evolution are used for therapeutic purposes the electrocoagulation; in cases of repeated relapses or clinical symptoms of proliferation of epithelial recommend radiation therapy.
Cm. also Precancer.