A 70-yrs-old man is concerned when his dentist finds a white

Discussion in 'MRCS Forum' started by Lona., Dec 14, 2007.

  1. Lona.

    Lona. Guest

    A 70-yrs-old man is concerned when his dentist finds a white patch on his oral mucosa during a routine exam. Proper management should include which of the following?
    a- Excisional biopsy of all lesions
    b- Application of topical antibiotics
    c- Low-dose radiation therapy
    d- Ascertaining that dentures fit properly
    e- Application of topical chemotherapeutic agents
  2. Lona.

    Lona. Guest

    Answer: d. (Schwartz, 7/e, pp 604, 610) White patches in the oral cavity (leucoplakia) sometimes are interpreted as a preliganant condition. Microscopic examination of leucoplakia may in fact reveal hyperplasia, keratosis or dyskeratosis, of which the last finding is the mot serious because of its association with malignancy. Only about 5% of patients with leukoplakia develop cancer. A suggested treatment protocol for patients with thin lesions advocates a program of strict oral hygiene and avoidance of alcohol and tobacco. Biopsy is reserved only for those with thick lesions (since carcinoma in situ may be present). Radiation therapy is contraindicated. Approximately 50% of all oral cancers occur in patients who have associated areas of hyperkeratosis and dyskeratosis. Chronic irritation, such as with poorly fitting dentures, may result in leukoplakia.

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