Are you up for a Q and A challenge (Leukoplakia)?
👋Hey peeps!
Hopefully you guys are up for a Q and A challenge today. Here's the deal. 👨🏫I'll ask you a bunch of questions and hopefully you would do some homework and answer them.
Mind you the questions, though not difficult, may require some reading. So feel free to browse our website or go through your textbooks for an answer. So, moving on to the questions!
📝Questions
A patient reported to the dental clinic and observation of the patient’s oral cavity revealed a red-white (or white-red) lesion. Clinical diagnoses of all other possible red-white lesions (like geographic tongue, lichen planus etc) were ruled out. The diagnosis could be??
Leukoplakia has more chances of malignant transformation than erythroplakia. Is this true?
Is a leukoplakia lesion considered to be dysplastic if it shows hyperplasia under the microscope?
Is "Tobacco pouch keratosis" a form of leukoplakia? Is it potentially malignant?’
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💡Scroll down👇 for the answers if you get stuck!
📚Here are some resources you could read from
Revision Ninja - Oral Pathology and Medicine(Notes, Videos & MCQs)
Neville BW, Damm DD, Allen CM, Chi A. Oral and Maxillofacial Pathology. South Asian ed. Elsevier; 2016.
Rajendran R, Sivapathasundaram B. Shafer’s Textbook of Oral Pathology. 7th ed. Elsevier; 2012.
Regezzi JA, Sciubba JJ, Jordan RCK. Oral Pathology: Clinical Pathologic Correlations. 5 th ed. Elsevier; 2007.
📚Study resources on HackDentistry!
Answers👇
A patient reported to the dental clinic and observation of the patient’s oral cavity revealed a red-white (or white-red) lesion. Clinical diagnoses of all other possible red-white lesions (like geographic tongue, lichen planus etc) were ruled out. The diagnosis could be??
Ans 👉 Remember that leukoplakia and erythroplakia are lesions that are diagnosed on exclusion. Hence the lesion in this example could be clinically diagnosed as leuko-erythroplakia or erythro-leukoplakia.Leukoplakia may reveal red patches or erythroplakia may reveal white patches manifesting as a mixed red-white lesion, called leuko-erythroplakia (speckled leukoplakia) or erythro-leukoplakia (speckled erythroplakia). This however has been a source of confusion for oral physicians and pathologists. All these terms are interchangeably used to describe leukoplakia with red components or erythroplakia with white components. However, clinical diagnoses for such “mixed” red-white lesions are subjective and what matters is that they have to be treated with caution. They have an increased risk of manifesting with dysplasia and malignant transformation.
Leukoplakia has more chances of malignant transformation than erythroplakia. Is this true?
Ans👉 Nope! While leukoplakia and erythroplakia are potentially malignant disorders, most erythroplakia lesions show dysplasia, carcinoma in-situ or squamous cell carcinoma and have a higher rate of malignant transformation than leukoplakia.
Is a leukoplakia lesion considered to be dysplastic if it shows hyperplasia under the microscope?
Ans👉 No, that’s not true! Hyperplasia is merely an increase in the number of cells. Though leukoplakia is potentially malignant it does not show dysplasia all the time. In fact many leukoplakia lesions often manifest with hyperplasia of the spinous layer (acanthosis) along with hyperkeratosis.
Is "Tobacco pouch keratosis" a form of leukoplakia? Is it potentially malignant?
Ans👉 Tobacco pouch keratosis is a distinct clinico-pathologic entity. It is not a form of leukoplakia. Snuff/finely powdered tobacco most times induces a lesion called “Tobacco pouch keratosis”. This is white keratotic and wrinkled lesion that resembles leukoplakia. It is important to distinguish this lesion from leukoplakia, as it usually disappears on cessation of the habit and also does not show dysplasia histopathologically. It is not potentially malignant.