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Thursday, May 17, 2012

Leukoedema

Leukoedema was first described in 1953 by Sandstead and Lowe. 


DESCRIPTION:   Leukoedema id characterized by a widespread whitening of the inner lining of the cheek oe other mouth tissues, due to an increase in the amount of fluid being retained by the skin’s cells. Leukoedema is persistant, and is most common in indivuals with dark skin. The cause of this condition is unknown.
Leukoedema is much like another abnormal condition, leukoplakia, in that both give the inner mouth tissues a white appearance. A simple test t overify the condition is to streatch the skin over the fingers; is the normal pink colour returns, it is leukoema. It is important that we distinguish leukoedema from leukoplakia, as leukoplakia can be pre-cancerous condition and should be biopsied for accurate diagnosis.
Leukoedema appears as a filmy, opaque, and white to slate gray discoloration of mucosa, chiefly buccal mucosa. Redundancy of the mucosa may impart a folded or wrinkled appearance to the relaxed mucous membrane. It partially disappears when the mucosa is stretched. It is stated to be seen in 90% of Blacks and 10-90% in Whites. This variation may be due to the difficulty in observation of leukoedema in  non-pigmented mucosa. Leukoedema is accentuated in smokers.

ETIOLOGY:   Leukoedema  is  a  variation  of  normal  that  should   not   be   confused   with   something   ominous.  Intracellular edema of the superficial epithelial cells coupled with retention of superficial parakeratin is thought to  account for the white appearance. Microscopic examination  reveals  superficial  squamous  cells  have  a  clear, seemingly  empty  cytoplasm  but  it  has  not  been  shown that there is an increase in intracellular water. Thus, the  term edema is questionable.

TREATMENT:  None required.

PROGNOSIS:  Good

DIFFERENTIAL DIAGNOSIS:  White sponge nevus, hereditary benign intraepithelial dyskeratosis, and dyskeratosis  congenital. All are extremely rare. 

Leukoedema




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