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Leukoedema - Oral Mucosal Lesion
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Leukoedema - Oral Mucosal Lesion

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Contributors: Carl Allen DDS, MSD, Sook-Bin Woo MS, DMD, MMSc
Other Resources UpToDate PubMed

Synopsis

Leukoedema is a whiteness of the oral mucosa that may be a normal variation since some studies show that up to 90% of the population has this condition although the stringency of criteria used in some studies are questionable. However, it may also represent mild topical or surface injury to the oral mucosa that is reversible and not severe enough to cause a break (ulceration) in the mucosa or even erythema and inflammation. The injury in leukoedema is very superficial. It occurs in up to one-third of the population who do not have a tobacco habit and in up to 70% of patients who have tobacco habits. It is likely even the use of mouth washes can result in this condition.
Blacks are noted to have a higher incidence of this and it may be because the whiteness of leukoedema shows up better overlying a pigmented mucosa.
Patients do not experience any symptoms with this condition.

Codes

ICD10CM:
K13.29 – Other disturbances of oral epithelium, including tongue

SNOMEDCT:
9816001 – Leukedema

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Lichen planus – This may have a reticular appearance but this does not disappear when the area is stretched.
  • Chronic use of astringent mouth washes can cause leukoedema initially but this may progress to actual desquamation and peeling of the mucosa.
  • Chronic bite injury (cheek chewing) – This has a shaggy, irregular surface configuration and may occur in a background of leukoedema.
  • Early smokeless tobacco keratosis – This may appear similar since the etiology is the same (topical injury).
  • Leukoplakia – This is denser in color and texture.
  • Inherited mucosal disorders such as Canon's white sponge nevus and hereditary benign intraepithelial dyskeratosis have a denser appearance and there is usually a family history of the disorder.
  • Candidiasis – This is usually painful and appears as curdy papules and plaques with surrounding erythema.

Best Tests

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Therapy

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Last Updated: 01/20/2015
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Leukoedema - Oral Mucosal Lesion
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Leukoedema : Buccal mucosa, Oral white plaque
Clinical image of Leukoedema
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