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Leukoplakia

Leukoplakia are patches on the tongue, in the mouth, or on the inside of the cheek.

Alternative Names

Hairy leukoplakia; Smoker's keratosis

Causes

Leukoplakia affects the mucus membranes of the mouth. The exact cause is not known. Doctors think it may be due to irritation such as:

  • Rough teeth
  • Rough places on dentures, fillings, and crowns
  • Smoking or other tobacco use (smoker's keratosis), especially pipes
  • Holding chewing tobacco or snuff in the mouth for a long period of time 
  • Drinking a lot of alcohol

The disorder is most common in elderly persons.

A type of leukoplakia of the mouth called hairy leukoplakia is caused by the Epstein-Barr virus. It is seen mostly in persons with HIV/AIDS . It may be one of the first signs of HIV infection. Hairy leukoplakia can also appear in other people whose immune system is not working well, such as after a bone marrow transplant.

Symptoms

Patches in the mouth usually develop on the tongue (sides of the tongue with hairy leukoplakia)and on the insides of the cheeks.

Leukoplakia patches appear:

  • Usually white or gray
  • Uneven in shape
  • Fuzzy (hairy leukoplakia)
  • Slightly raised with a hard surface
  • Unable to be scraped off
  • Painful when the mouth patches come into contact with acidic or spicy food

Exams and Tests

A biopsy of the lesion confirms the diagnosis. Examination of the biopsy may find changes that indicate oral cancer .

Treatment

The goal of treatment is to get rid of the leukoplakia patch. Removing the source of irritation may cause the patch to disappear.

  • Treat dental causes such as rough teeth, irregular denture surface, or fillings as soon as possible.
  • Stop smoking or using other tobacco products.
  • Do not drink alcohol.

If removing the source of the irritation does not work, the doctor may suggest applying medicine to the patch or using surgery to remove it.

For hairy leukoplakia, taking antiviral medicine usually causes the patch to disappear. The doctor may also suggest applying medicine to the patch.

Outlook (Prognosis)

Leukoplakia is usually harmless. Patches in the mouth often clear up in a few weeks or months after the source of irritation is removed.

In some cases, the patches may be an early sign of cancer. 

When to Contact a Medical Professional

Call for an appointment with your health care provider if you have any patches that look like leukoplakia or hairy leukoplakia.

Prevention

Stop smoking or using other tobacco products. Do not drink alcohol, or limit how many drinks you have. Have rough teeth treated and dental appliances repaired promptly.

References

Allen CM, Camisa C. Oral disease. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, Pa: Elsevier Saunders; 2012:chap 72.

Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Philadelphia, Pa: Elsevier Mosby; 2009:chap 21.

Mendoza N, Madkan V, Sra K, et al. Human herpes viruses. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, Pa: Elsevier Saunders; 2012:chap 80.

Updated: 9/1/2013

Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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