Leukoplakia
Leukoplakia is a white lamellar plaque capable of affecting the mucous membranes of various organs, gradually leading the epithelium to keratinization of various degrees of complexity and to variants of degeneration of healthy tissues into malignant ones. In the not so distant history of medicine, leukoplakia was considered a type of stomatitis. Today, this disease has acquired a threatening coloration as a precancerous condition of an organ or a section of the mucous layer. Especially often, leukoplakia affects the mucous layers of the cheek, the bottom of the oral cavity, the back or sides of the tongue with the exit openings of its glands. A little less often, the corners of the mouth, lips, and respiratory tract become the foci of its occurrence. The last decades have been marked by the widest spread of leukoplakia on female and male genitourinary organs, changing the mucous coating of the vulva, clitoris, vagina, cervix, penis, the environment of the anus, bladder. Less often, the disease attacks the gastric mucosa.
The content of the article:
Classification of leukoplakia
Causes of leukoplakia
Symptoms of leukoplakia
Diagnosis of leukoplakia
Treatment of leukoplakia
Leukoplakia
Classification of leukoplakia
Leukoplakia, which is a very unpleasant and progressive disease, manifests itself in the following forms:
Flat leukoplakia looks like a continuous turbidity of the mucous focus in the form of a film that cannot be scraped off with a spatula. Depending on the intensity of the increasing keratinization, the color of the focus varies from light gray to white with sharply limited jagged edges without seals. The dry and rough surface of the leukoplakia can cause a feeling of tightening, have reddening of the skin at the edges. The flat form of the disease, located on the inside of the cheeks, is characterized by folding, and located under the tongue is a wrinkled grayish-white shade.
The verrucous form of leukoplakia is also called warty, since its dense white, like milk, plaques rise above the flat leukoplakia by two to three millimeters in the form of tubercles. This form of the disease is a precancerous condition.
Erosive leukoplakia is the next stage of a complicated disease, because it overlaps with the two previous forms of leukoplakia, covering the epithelium with erosions of various shapes and sizes. Such a thick layer of keratinization of the mucous membranes can crack, cause pain, burning, discomfort, complicate the vital processes of the patient and lead to the formation of malignant growths.
Smokers’ leukoplakia or nicotine leukoplakia develops only in smokers and is revealed by the appearance of “mother-of-pearl” plaques on the mucous layer in the corners of the mouth. Grayish-white, completely keratinized foci on the back, sides of the tongue with adjacent areas of the soft palate are covered with red dots, which are nothing more than gaping mouths of salivary glands.
Sometimes the symptoms of leukoplakia occur on the red border of the lips, more often on the bottom. In the later stages of leukoplakia, a number of nodules with a red dot at their apex are added. This form of leukoplakia has similarities with Darya’s disease, however, unlike it, it completely disappears after quitting smoking and almost never develops into a malignant form.
Causes of leukoplakia
What awakens this disease, modern doctors cannot accurately determine and explain. The dominant factors provoking the occurrence of foci of leukoplakia can be both circumstances depending on the patient himself or beyond his control. The main causes of malignant degenerations in the human body are external factors:
echoes of modern technological progress;
development of chemical, nuclear and other industries harmful to humans;
low-quality food products;
unusable drinking water;
polluted environment and atmosphere.
Many reasons for the occurrence of leukoplakia consist of a fatal fusion of external and internal factors:
Activation of factors that cause leukoplakia of the oral cavity and respiratory tract is most often provoked by people who abuse alcohol and tobacco smoking, when the mucous membrane of the lips, oral cavity, lungs are affected by the chemical components of alcohol and cigarette smoke, settling resins. The factor of frequent cauterization of the lips when smoking to the very end of a cigarette / cigarette or permanent injury to the mucous coating with a mouthpiece also leads to the progression of the disease.
In addition, the causes of leukoplakia are factors that a person does not actually focus on:
untreated teeth in time;
burns by hot food/drink;
poorly fitted dentures or metal dentures that irritate the oral mucosa.
Leukoplakia of the genitourinary organs can be provoked by other causes. For example, cervical leukoplakia is most often caused by the procedure of cauterization with a high-frequency alternating electric current of great strength, which is considered very traumatic for the mucous coating of the organ. Frequent diseases and processes of an inflammatory nature can also push to the formation of a focus of leukoplakia.
Gastrointestinal pathologies present in 90% of patients may cause the appearance of leukoplakia of the gastric mucosa.
Genetic predisposition to keratoses of various etiologies, combined with other health disorders, lack of vitamin A metabolism or lack thereof, excessive fascination with solar irradiation can also cause the development of the disease.
There are some similar in appearance and sensations inflammatory erosive processes in the mouth, which should be accurately diagnosed, and then completely cured.
Symptoms of leukoplakia
The symptoms of various forms and locations of leukoplakia can manifest themselves in a variety of ways. Most often, this disease occurs and proceeds without negative sensations, except for leukoplakia of the larynx and urinary tract. The leukoplakia clinic is characterized by:
the form of the disease;
the factor that caused it;
localization of keratinization.
The development of leukoplakia from its first manifestations to the stage of transition to a malignant state can be divided into the following stages:
The stage preceding the manifestations of leukoplakia, when a small focus of inflammation of the mucous membranes has a limited localization of grayish color, but the next moment its rapid keratinization begins with a change in color to white.
The stage when, with the further progression of the disease, the affected area rises above the adjacent healthy mucous membrane (verrucose form). It is such a sign during the course of the disease, when metaplastic changes replace hyperplastic ones, often there is a transition to a malignant state.
The stage of development of the erosive form of leukoplakia is the most risky in terms of the growth of malignant tumor formations and is characterized by the appearance of dense erosions that can crack and cause pain. In cases where a seal appears in one place under a common keratinized layer, there is a dangerous sign of a transition to a malignant stage.
The defining symptoms of leukoplakia in the bladder are:
dull, continuous pain in the lower abdomen and in the perineum area;
cutting;
itching;
discomfort when urinating.
In order not to confuse the symptoms with the appearance of cystitis, you need to undergo various studies.
Symptoms of laryngeal leukoplakia include:
the appearance of hoarseness of the voice;
unpleasant feelings when talking;
cough.
Therefore, we can say that all forms of leukoplakia differ in belonging to a single pathological process when one stage passes into another. Approximate statistics on the ages of people exposed to leukoplakia speak of patients aged 30 to 50 years, rarely up to 60, and it is claimed that men are more predisposed to the disease than women. There are rare mentions of the detection of children and adolescents with leukoplakia.
Diagnosis of leukoplakia
In addition to visual examination of the patient by a doctor, in order to make an accurate diagnosis, the patient should undergo a number of procedures and tests:
general urine examination;
bacterial culture of urinary fluid;
the test on Nechiporenko;
analysis to search for atypical cells in the mucous membranes of the bladder and ureters;
general and biochemical blood tests to identify possible changes in blood parameters;
an immunogram is a blood test aimed at establishing any traces of changes in the immune system;
tests that determine the presence (or absence) of trichomonas, chlamydia, mycoplasmas, ureaplasmas, infection of which can only be sexually transmitted;
Ultrasound of the bladder, uterus and appendages, which will determine and usually concomitant diseases such as endometritis, inflammation of the ovaries, cervical erosion, which are foci of infection and provocateurs of inflammatory processes in the ovaries, uterus, vagina, bladder;
biopsy to clarify the real diagnosis, if fibrourethrocystoscopy indicates the presence of transformations on the mucous membrane;
histological examination of the mucous membranes of the oral cavity in case of doubts about clinical data, allowing to differentiate leukoplakia with other diseases, such as lichen planus, lupus erythematosus, as well as with some forms of candidiasis and syphilis, in order to identify tissue transformation;
cytological examination to determine possible cellular modifications in the direction of oncology.
Leukoplakia is often mistakenly considered to be mild leukoplakia, which is more often affected by very young representatives of the population and women. Elderly men suffer from a typical type of disease, which is caused by excesses in the use of alcohol and tobacco smoking. Partial keratinization of tissues is present in both forms of leukoplakia.
It was determined that almost 90% of patients bite the particles of the oral mucosa, and then you can notice white foci on the bite marks. The typical form of leukoplakia affects young people and middle-aged patients, and in the elderly, clusters of keratinized foci on the lower lip areas are viewed as pre-oncological hyperkeratosis of the red lip edging.
Treatment of leukoplakia
Leukoplakia passes as a chronic disease. However, with the elimination of the irritating factor or a sharp decrease in its impact, with extensive rehabilitation of the body, a stop in the spread of the disease may occur, and conducting competent conservative therapy may lead to its regression. Otherwise, the disease will steadily progress and may result in transformation into cancer, which usually occurs at the verrucous and erosive-ulcerative stages of leukoplakia.
Comprehensive treatment of leukoplakia provides for the exclusion of factors that were catalysts for the appearance and progression of leukoplakia. Here you can designate the following activities:
rejection of metal dentures;
restoring vitamin A metabolism;
giving up bad habits;
treatment of painful abnormalities in the gastrointestinal tract, organs of the endocrine and other body systems identified by a complete examination of the patient;
getting rid of somatic diseases, sources of inflammation and infections.
When a diagnosis of “leukoplakia” is made, treatment of its various localizations should be carried out under medical supervision within the framework of traditional medicine, and not use folk and medicine men’s methods so as not to harm yourself. Although this disease is difficult to treat, however, the following methods will help keep the disease under control, prevent it from progressing or get rid of it for a long time.
Simple leukoplakia, which does not have atypical cells, usually does not need radical methods of treatment, although such patients should be monitored with periodic passage of a complex of studies.
If atypia is confirmed in the tissues and cells of the patient’s diseased organs, immediate removal of leukoplakia foci by radio wave method or using a laser, by cauterization with high-frequency alternating currents and excision with an electric knife is required.
Liquid nitrogen should not be used because of the appearance of rough scars in the places of its application.
In severe cases of leukoplakia of the labia, urinary system, cervix, surgical intervention is required to excise focal lesions on the mucous membranes and remove areas of diseased organs, which may subsequently require reconstructive organ surgery.
When detecting malignant changes in the tissue and cellular structure of the organs affected by leukoplakia, the patient needs radiation therapy.
Microlaryngological surgery is applied to laryngeal leukoplakia.
It is possible to treat leukoplakia of the bladder by injecting ozonated liquid or oil into it. Also, gaseous ozone is used for these purposes, and in case of severe lesions, surgical excision of a part of the bladder is performed.
Medications against fungal, bacterial, inflammatory and viral processes give excellent results in the treatment of concomitant diseases. There are positive results from the use of solkovagin, which completely and painlessly destroys the focus of the disease.
Cryotherapy is a successful method of treating leukoplakia, which helps to get rid of the source of the disease by low—temperature exposure.
High—intensity laser treatment is the most productive and painless method of removing foci of leukoplakia and modified tissues.
