Leukoplakia

Diagnosis

The diagnosis of leukoplakia involves inspecting the mouth for any abnormal white patches, determining the cause of the symptoms, and discussing one’s medical history and potential risk factors. People diagnosed with hairy leukoplakia is likely to undergo examinations to identify potential underlying conditions that could weaken the immune system.

Generally, a confirmed diagnosis of leukoplakia requires biopsy. Two types of biopsies commonly used include:

• Excisional biopsy: This type can provide a definitive diagnosis. If the entire leukoplakia patch is removed, additional treatment may not be necessary even if the biopsy reveals malignancy. If the patch is large or not entirely removed, further treatment may be required. A tiny sample of tissue is taken out of the leukoplakia patch for this test.
• Oral brush biopsy: The diagnosis may still be uncertain even after this test. Using a tiny, rotating brush, cells are scraped from the patch’s surface during this test.

Treatment

Treating leukoplakia typically focuses on removing patches from the mouth. For many people, resolving the condition involves addressing the underlying source of irritation, such as quitting tobacco or alcohol use. Achieving effective treatment is more feasible when leukoplakia is detected and addressed early, especially when the patch is small. It’s essential to undergo regular checkups and self-monitoring for any changes in the cheeks, gums, and tongue to facilitate early detection.
Treatment plan may involve:

• Surgery: The sole effective method for eliminating leukoplakia is through surgical intervention, wherein the patch in the mouth is removed using various techniques. These may involve the use of a scalpel for direct removal or alternative procedures.

Alternative methods include using a laser, administering light-activated cancer drugs through photodynamic therapy, applying cryotherapy, or utilizing an electrically heated needle or other instruments for removal through electrocauterization.

• Scheduled appointments for monitoring:  Research indicates that leukoplakia may reoccur in approximately 15% of cases following its removal. People who had surgery to eliminate leukoplakia may be advised of regular follow-up appointments for several years, typically recommending visits every six to 12 months.

Treatment for hairy leukoplakia

Treatment options may include the use of antiviral medications in pill form to control the Epstein-Barr virus responsible for hairy leukoplakia. Alternatively, direct application of treatment to the affected patch might be considered. It is advisable to have regular follow-up visits to monitor any changes in the mouth because the white patch may reappear after discontinuing treatment. Generally, hairy leukoplakia typically does not require treatment as it often does not cause symptoms and is unlikely to develop into mouth cancer.