ERYTHROPLAKIA

 ERYTHROPLAKIA

INTRODUCTION:

It is a red patch that cannot be clinically or pathologically diagnosed as any other condition and is relatively rare compared to leukoplakia. Erythroplakia is almost associated with premalignant changes histologically and is, therefore, a most important precancerous lesion.

ETIOLOGY:

i. Unknown

ii. Smoking and alchohol abuse 

CLINICAL FEATURES:

- No apparent sex predilection.

- Most cases occurred in sixth and seventh decades of life.

Sites: Floor of mouth, tongue, retromolar area, soft palate, mandibular mucosa and sulcus.

-  Appears clinically well-demarcated, erythematous, macule/papule with a soft velvety tissue

- Usually asymptomatic

CLASSIFICATION:

i. Homogenous

ii. Erythroplakia interspersed with patches of leukoplakia

iii. Granular or speckled erythroplakia

HISTOPATHOLOGICAL FEATURES:

- Multicentric in origin and severe epithelial dysplasia is seen.

- The epithelium shows lack of keratin production and is often atrophic but it may be hyperplastic.

- Lack of keratinization and thining of epithelium allows underlying vasculature to be seen causing red colour.

- Connective tissue rete pegs are high into the epithelium.

- The underlying connective tissue often demonstrates chronic inflammation.

TREATMENT:

- Remove irritating agents.

- Prompt biopsy is mandatory.

- Recurrence rate of less than 5% is reported.