Erythroplakia - Images, Symptoms, Causes, Cancer Risk, Treatment

There are three types of Erythroplakia:

1. Homogenous erythroplakia
2. Erythroplakia inter spread with patches of leukoplakia
3. Granular or speckles leukoplakia

Disease Progression of Erythroplakia

Erythroplakia is generally considered a precancerous condition. The rate of transformation of erythroplakia into cancer is 14 to 50 per cent. Compared to leukoplakia (white oral lesions), erythroplakia has a significantly higher risk of developing oral cancer.
 

In most cases, the erythroplakia does not seem to show any symptoms. Therefore, the patient may not know it until the dentist figures it out during the routine oral examination. The patient can also notice it during brushing and flossing the teeth.

1. If the lesion occurs on the vocal cords, then it may cause the voice to change, which is easily noticeable.
2. Hoarseness of voice

Red lesions characterise Erythroplakia in the oral cavity that may be caused due to irritation and long-term trauma to oral tissues. The causes of erythroplakia are:

1. Chewing tobacco
2. The dentures that do not fit properly in the mouth and rub the gum against other tissues may cause the erythroplakia lesion.
3. Heavy smoking
4. Excessive intake of alcohol

1. Age: Erythroplakia can occur to a person of any age, but it is more caused to persons of middle age and older people.
2. Gender: Recently, it has been found that erythroplakia occurs more often in men. In a recent study conducted on about 58 persons, it has been found that it occurs in both males and females.
3. Smoking: Smoking increases the chances of erythroplakia.

Erythroplakia can be prevented through the following measures:

1. Avoid drinking alcohol, chewing tobacco, and smoking
2. Practising good oral hygiene
3. Routine dental checkups (especially for those at increased risk of erythroplakia)
4. Avoid wearing poorly fitted dentures

Oral erythroplakia does not cause any pain or symptoms, it will remain unnoticed until it starts causing discomfort to the patient. If the dentist suspects erythroplakia, they will address some tests using gauze and palpation. The doctor asks some questions of the patients to rule out cases of trauma. According to the American Cancer society, if the lesions bleed easily, there is a higher chance of erythroplakia. For locating the erythroplakia, a staining test may also be ordered. The procedure for the staining test is as follows:

1. Rinsing: The patient is asked to rinse the mouth for 20 seconds using water. After this, the patient is asked to rinse the mouth again using a 1% acetic acid solution.  
2. Drying of area: The mucosal areas are then dried using gauze. It is taken care that the gauze does not irritate the mucosal cavity.
3. Application of toluidine blue solution: 1% toluidine solution is applied to the mucosa using a cotton swab. 
4. Rinsing: The patient is asked to rinse their mouth using a 1% acetic acid solution followed by a rinse with sterilised water. The dark blue staining in the oral cavity may indicate erythroplakia.

Your doctor might merely advise making lifestyle changes, such as quitting smoke to treat erythroplakia.

Erythroplakia Treatment without Surgery

1. If the lesions of oral erythroplakia are not causing any symptoms, there is no need for treatment. However, the patient should regularly visit the doctor to evaluate the progression of the disease. 
2. When the erythrocyte is identified, the doctor will first recommend a biopsy of the present lesions. The biopsy is essential to find out whether the lesion is cancerous or not. It helps the doctor in starting the treatment accordingly. 
3. If the doctor suspects that the lesion is due to alcohol or tobacco during diagnosis, they may ask the patient to quit those things.

Erythroplakia Treatment with Surgery

The most recommended treatment for the cancerous lesion is the excision of the lesions, along with severe follow-up examinations. These follow-up examinations must show no recurrence of erythroplakia. Follow-up examinations are more important in the case of excision surgery because the chances of recurrence are very high. Depending upon the level of the oral infection, the following types of treatment have been recommended for treating oral erythroplakia:

1. Laser surgery: The continuous focus of the laser beam on the cells results in more absorption; hence, cells become overheated by the heat energy and eventually get destroyed.
2. Cryosurgery: In this process, a freezing liquid like liquid nitrogen or argon is focused on the site where the cancerous cells are present. Prolonged exposure to these gases will cause the cells to shrink, eventually destroying the cancerous cells.

Some of the complications related to erythroplakia are:

1. Abnormality in the tongue
2. Changes in the oral health 
3. Occurrence of lesions on oral mucosa
4. Progression to cancer

When to consult a doctor for Erythroplakia?

It is essential to consult a doctor if the person experiences any visible changes in the oral mucosal layer, such as:

1. Oral growth (lesion) which does not go away in 1 or 2 weeks
2. Warning signs in biopsy (the treatment should be started immediately).