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Oral erythroplakia - Oral Mucosal Lesion
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Oral erythroplakia - Oral Mucosal Lesion

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Contributors: Carl Allen DDS, MSD, Sook-Bin Woo MS, DMD, MMSc
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Synopsis

Erythroplakia is a pre-malignant condition of the oral mucosa (similar to erythroplasia of Queyrat) that typically appears as a demarcated red patch that clinically cannot be diagnosed as any other condition. One study suggested that greater than 90% of such lesions are dysplastic, carcinoma in situ, or invasive carcinoma at the time of diagnosis.

Erythroplakia tends to occur in older individuals. The lesions may be painless, tender, or painful. In some instances, the lesions are not just red but admixed with white areas, and these have been termed "erythroleukoplakia" or "speckled leukoplakia." Patients often have a history of cigarette smoking. The lesions are often painless, so the patient may not be aware of how long they have been present. If not treated, the lesions will continue to grow over months and years and eventually develop invasive carcinoma.

Codes

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

SNOMEDCT:
69299000 – Oral erythroplakia

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Migratory glossitis – Associated with a linear white raised rim and usually located on the lateral aspect of the dorsal tongue. Lesions resolve and develop in another site. Infrequently, this process will occur on other oral mucosal surfaces (ectopic geographic tongue), but nearly always in conjunction with tongue lesions.
  • Lichen planus – Usually painful and associated with peripheral white striations.
  • Desquamative gingivitis – Appears as a painful erosion and sloughing of the gingiva and should be biopsied for a definitive diagnosis.
  • Denture stomatitis – Occurs beneath a maxillary denture and is confined to the area that the denture covers. It is typically asymptomatic. Disinfecting the denture and leaving it out of the mouth at night should resolve the lesion.
  • Contact stomatitis and chemical burns – Usually painful and associated with placement of a noxious agent against the mucosa.
  • Erythematous / atrophic candidiasis – May be asymptomatic ("central papillary atrophy of the tongue") or have a burning sensation if diffuse involvement of the dorsal tongue is present. Typically, this resolves with anti-fungal agents.

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Therapy

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References

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Last Updated: 07/25/2013
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Oral erythroplakia - Oral Mucosal Lesion
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Oral erythroplakia : Buccal mucosa red plaque, Oral mucosa, Oral red macule, Smoker
Clinical image of Oral erythroplakia
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