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