Erythroplasty of the oral cavity

Erythroplasty of the oral cavity is a persistent red spot. It has no clinical manifestations. In most cases, neoplasm is characterized as epithelial dysplasia. The whole danger lies in the fact that the tumor is capable of passing into a malignant form. Usually, everything is localized on the mandibular fold in the oropharynx, the tongue and the mouth of the mouth. The patient does not complain about anything, he does not pester him. It appears in people older than 55 years, both in women and men.

ICD-10 code

Thanks to a specially created international classification, each disease was assigned its own unique code. So, diseases of the oral cavity, salivary glands and jaw are designated as K00-K14. K00 Developmental and teething disorders. Excreted and impact teeth are excluded.

• K01 Retina and impact teeth. Excluded only those that have an incorrect position in relation to neighboring teeth.
• K02 Dental caries.
• K03 Other diseases of hard tissues of teeth. Bruxis, tooth decay and teeth grinding of BDU are excluded.
• K04 Diseases of pulp and periapical tissues. K05 Gingivitis and periodontal disease.
• K06 Other changes in the gingiva and toothless alveolar margin. There is no atrophy of the toothless alveolar margin, and gingivitis.
• K07 Maxillofacial anomalies [including bite abnormalities]. Excludes atrophy and hypertrophy of the half of the face (Q67.4) unilateral condylar hyperplasia or hypoplasia (K10.8).
• K08 Other changes in the teeth and their supporting apparatus.
• K09 Cysts of the mouth region, not elsewhere classified. This includes lesions with histological features of the aneurysmal cyst and other fibrotic-bone lesions. Excludes the root cyst (K04.8).
• K10 Other jaw diseases.
• K11 Disease of the salivary glands.
• K12 Stomatitis and related lesions. Excludes splitting mouth ulcer (A69.0) cheilitis (K13.0) gangrenous stomatitis (A69.0) gingivostomatitis caused by the herpes virus.
• K13 Other diseases of the lips and mucous membrane of the mouth. These include changes in the epithelium of the tongue. Completely excluded: some changes in the gingiva and toothless alveolar margin (K05-K06) cysts of the mouth area (K09) of the disease of the tongue (K14) of stomatitis and related lesions (K12).
• K14 Diseases of the tongue. Excludes erythroplasty, focal epithelial, tongue hyperplasia (K13.2) leukemia, leukoplakia, hairy leukoplakia (K13.3) macroglossia (congenital) (Q38.2) submucosal fibrosis of the tongue (K13.5)

Causes of erythroplasty of the mouth

People who have addictions are at risk. It concerns alcohol and tobacco. And smoking is not necessary, enough, just use chewing tobacco, the result will be similar. The combination of alcohol and tobacco several times increases the risk of cancer. Most often suffer from this pathology of men, but because of the sharp increase in women smokers, there is no difference between the sexes. All are susceptible to tumor formation.

Cigarettes, pipes and cigars significantly increase the risk of malignant tumors in the human mouth. Especially often this occurs at the place of contact between the cigarette and the lips. First there is a speck that looks like a birthmark. By means of a biopsy it is possible to define a malignant speck or not.

Broken teeth are also capable of provoking the development of erythroplasty. Prostheses and seals have a similar effect. There is a risk of developing a malignant tumor. People who have previously tolerated this pathology, the risk of recurrence is great.

[1], [2],

Pathogenesis

Among all oral lesions, cancer is most common. Education can be either benign or malignant. The beginning of the process is really explained. This is the case from the point of view of the polytheological theory of origin. Any damage, whether mechanical irritation, temperature, chemical or biological factors - all this negatively affects the oral cavity. Unsatisfactory condition of the mouth, poor hygiene and other "little things" can aggravate the situation. All this individually or in combination leads to problems with the oral cavity. In almost 50% of cases, erythroplasty occurs against the background of carious teeth. Orthopedic structures cause tumors in 10%.

As for the etiological factors, smoking, laying under the tongue of NASA, chewing betel and burns with ethyl alcohol exert special influence. All this leads to damage to the mucous membrane of the mouth and as a consequence of this - the tumor. Constant heating and toxicity of tobacco can cause neoplasm.

Symptoms of erythroplasty of the mouth

The whole danger is that a person does not complain about any discomfort. Usually, erythroplacia does not manifest itself in any way, until it becomes a malignant tumor. You can see the changes only visually. So, on the mucous membrane of the mouth can appear bright red spots. Many people do not pay attention to this, and very vainly. Those who are frightened by this "symptom" are referred to a hospital. The doctor collects an anamnesis from the patient regarding his lifestyle and his bad habits.

This pathology is characterized by the presence of limited bright red spots. In addition, there may be small soft nodules, with palpation of which there are painful sensations. With a thorough examination of the mouth, you can see a few red spots in different areas. This should alert the person. This color is provoked by atrophy of the mucous membrane, as a result of which the vessels that are in the submucosa base become visible.

You can see the spots in the area of molars and on the mucous membrane. Usually they are located on the transitional fold of the lower jaw, tongue and bottom. Sometimes patients are symptomatic of both erythroplasty and leukoplakia. This condition several times increases the risk of developing cancer.

First signs

The first thing is a swelling and thickening of the lesion on the mucous membrane of the mouth. Seals can be probed, as well as cones. Some areas become rough, covered with crusts and outwardly resemble small erosion. There are velvety white or red spots. Basically, they appear on the inside of the mouth.

Soreness and other discomfort is not observed. There may be an unreasonable bleeding in the mouth. Numbness, loss of sensitivity of a particular area, soreness - appear in later stages. More precisely, only with malignant flow.

Evidence of the problem can be chronic ulcers located on the face, neck and in the mouth. They are able to bleed slightly and not heal for 2 weeks or more. In the pharyngeal region, sensations of the presence of a foreign body can appear. When chewing, there is discomfort, pain and change in taste. All this is characteristic of later stages.

[3], [4]

Effects

Do not pay attention to the problem can not be. After all, erythroplasty is a precancerous condition. If you do not start treatment on time, then the tumor can become malignant. As a consequence of this - a lethal outcome. Treatment should be correct and include several techniques. Usually, pathology is eliminated with radiation and chemotherapy. Eliminates all surgically.

The consequences are affected not only by the treatment provided, but also by the recovery period. It is important to correctly diagnose pathology, determine the size of the tumor, its location and damage to adjacent tissues.

After the surgery, many patients experience weakness and general malaise. This is quite normal. It all goes on its own in about a few weeks. Timely treatment guarantees success. If you do not pay attention to erythroplasty, it becomes malignant and the only consequence can be a fatal outcome.

[5], [6]

Complications

Without proper treatment, complications can be irreparable. It should be noted that the problem is eliminated by means of chemotherapy, radiation therapy and surgical intervention. Eliminate the pathology of medicines can not. Moreover, without qualitative treatment of erythroplastya and oral cavity will take a malignant form.

Correct elimination is the diagnosis. So, it is important to determine not only the location of the spot localization, but also its size, as well as the factors that led to such an event. Then treatment is prescribed. Usually it is complex and begins the removal of that very education. Leave it or eliminate it with medicines. A spot will not succeed.

If a person starts treatment on time, there will be no complications. There can be only two of them. The first option - the transition to malignant form, the second option - a lethal outcome. The importance and efficiency of the actions will help a person to avoid both severe symptoms and serious consequences.

[7], [8], [9], [10], [11], [12]

Diagnostics

The attending physician should carefully examine the oral cavity. Particular attention is paid to the hyoid area. In addition, the examination requires a visit to a specialized medical institution. Inspection is carried out using a special mirror, as well as a lamp. To make sure there are no sores in the throat, you will have to use an endoscope with a thin flexible tube and a light bulb at the end.

In order to make a diagnosis, you will have to undergo a biopsy. To do this, the doctor removes a tiny area and examines it under a microscope. This procedure is carried out exclusively under general anesthesia. Therefore, a person will have to spend some time in the hospital. After that, further examination is carried out.

To assess a person's condition, it is necessary to take a blood test, as well as to conduct a chest X-ray. It is important to examine the oral cavity for the presence of metastases. Based on the results of the analysis, quality treatment is prescribed. In some cases, the lesion affects the bones, as well as individual parts of the facial part of the skull. To determine the presence of a problem, it is necessary to perform an orthopantogram.

Widely used and magnetic resonance imaging. Thanks to it you can study in detail the tissues and organs. Before the procedure, the patient is asked to remove all metal objects and jewelry from his body.

A special role is played by computed tomography. A number of X-ray photographs will allow us to examine the oral cavity layer by layer and get acquainted with all the pathologies present in it. Before the procedure a person should not drink and eat for 4 hours. In case of complications, a bone scan is performed. This will allow to see the pathological changes in the facial sections of the skull.

[13], [14]

Analyzes

In order to examine the affected area, you will have to undergo a biopsy. The procedure is the taking of tissues from the site of tumor localization and its detailed study under a microscope. During the procedure, a person is anesthetized. The resulting material should be sent for histological examination. Experienced laboratory doctors study the tissue site and make their conclusions. Usually, in the presence of a tumor, changes that are characteristic of a certain type of neoplasm are revealed.

In addition to biopsy, a person must pass a blood test. Thanks to it, it becomes possible to study the affected area and reveal changes in it at the cellular level. Here we also see pathological changes concerning enzymes, metabolites and some oncomarkers. These analyzes are submitted in aggregate. Thanks to them you can get a complete picture of what is happening and prescribe a quality treatment.

[15], [16]

Instrumental diagnostics

This method of diagnosis includes several main areas. So, the first thing a person needs is to undergo nasopharyngoscopy. Thanks to this procedure, it becomes possible to study the back wall of the oral cavity more thoroughly for the presence of pathological changes in it.

Pharyngoscopy and laryngoscopy are widely used. These procedures are necessary for examination of the mucous membrane of the larynx and trachea. With a possible complication with the facial lesion of the skull, radiography of the bones is performed. It allows to identify the main foci of tumor growth.

Scintigraphy. The procedure is a study using radioactive isotopes. This is an informative examination that helps to detect the presence of metastases in bone tissue.

Computer, magnetic resonance and positron emission tomography. These diagnostic methods help to clarify the nature of the lesion, as well as the extent of the lesion. All the above procedures can be used individually or in combination.

Differential diagnostics

This method of research includes several methods. So, in addition to using instrumental diagnostics, it is worth taking a fence of the affected tissue and donating blood for tests. So, a person who has suspicions of erythroplasty of the oral cavity should go through a biopsy procedure. It represents a carving of a small affected area. For this person to be influenced by general anesthesia. The cut out site is given for histological examination. Under a microscope, it is studied for the presence of pathological processes.

In addition to the biopsy will have to pass and a blood test. Any changes in the body are immediately visible in the blood. So, the material can be used to study the cellular composition and make sure that there are changes in the indices. Usually, the neoplasm changes enzymes, metabolites and some oncomarkers. Thanks to these two procedures, and in combination with instrumental diagnostics, you can not only put the right diagnosis and prescribe quality treatment.

[17], [18], [19], [20]

Treatment of erythroplasty of the oral cavity

To solve the problem, the surgical, radiation and drug method is used. Much depends on the condition of the person and the area of injury. The method of treatment is chosen by the doctor on the basis of the received diagnostic data.

Surgery. To eliminate the tumor, various methods are used. Usually removes the moving part of the oral cavity and the oropharynx. In this case, the bones are not affected. In case of damage to the facial part of the jaw, the affected area is sawed. More details about the surgical method of treatment will be described below.

Radiation therapy. This method is the main method of treatment for people with neoplasms in the oral cavity and oropharynx. The procedure is used in conjunction with an operation whose main purpose is to remove the affected area. External radiation is often used. Treatment should be done 5 times a week for 5-7 weeks. Some patients are prescribed brazitherapy. It is internal irradiation. In the tumor and areas located near it specialists introduce special metal rods, which are based on radioactive material. When a person is discharged home, the rods are eliminated. In most cases, both external and internal irradiation are actively used. The technique has side effects. They will be included in the redness of the skin, dryness, pain syndromes in the pharynx, as well as weakness and loss of taste. Complications can be damage to the thyroid gland and blood vessels.

Chemotherapy. By this technique is meant the use of special antitumor drugs. Use this method can be combined with surgical removal and radiotherapy. This will not only eliminate the tumor itself, but will not lead to complications. As drugs used Cisplatin, fluorouracil, docetaxel, paclitaxel and gemcitabine. Detailed information about them will be provided below. Chemotherapy can cause a number of side effects. These include nausea, vomiting, general weakness and loss of appetite. The person is being tormented by fatigue, and there is also an increased susceptibility to infection.

Medicinal treatment

Independently any medicines are not applied. Most of them are included in the complex elimination of the problem, namely one method - chemotherapy. Cisplatin, Fluorouracil, Docetaxel, Paclitaxel and Gemcitabine are widely used.

• Cisplatinum. The agent can be used both separately and in complex therapy. Dosage is assigned individually and depends on the patient's condition. Usually, 20 mg per square meter is administered. Introduction is carried out for 5 days daily, then between courses are left for 3 weeks. The medication has a number of side effects, it can disrupt the liver and kidneys, lead to nausea, vomiting and general malaise. Contraindications: hypersensitivity, ulcer, pregnancy, impaired liver and kidney function.
• Fluorouracil. It is used to eliminate tumors, malignant type. Dosage is appointed by the attending physician. It is enough 15 mg per one kilogram of weight. The introduction is carried out for 4 hours. The frequency of use and duration are selected individually. Contraindications: hypersensitivity, severe diarrhea, pregnancy, infectious diseases, impaired liver and kidney function. Side effects: nausea, vomiting, impaired liver and kidney function, confusion.
• Docetaxel. The drug is used exclusively intravenously. It is enough 0.74 mg per ml. The introduction is carried out for 4 hours. Duration of use of the drug is discussed individually. Contraindications: hypersensitivity, liver failure, the period of breastfeeding and pregnancy. Side effects: nausea, vomiting, fatigue, impaired liver and kidney function, erythema, skin itching.
• Paclitaxel. Dosage is assigned individually, depending on the condition of the person, as well as the tumor. Contraindications: hypersensitivity, pregnancy, lactation and neutropenia. Side effects: anemia, nausea, vomiting, diarrhea, allergic reactions, necrosis.
• Gemcitabine. Introduced the drug intravenously and drip for 30 minutes. It is advisable to use it not more than once a week. The duration of the course is 3 weeks. Re-introduction no earlier than 7 days. Contraindications: hypersensitivity, pregnancy and lactation. Side effects: headache, nausea, weakness, vomiting, diarrhea, constipation, stomatitis.

Alternative treatment

In cancer and precancerous formations, the use of alternative medicine is a little inappropriate. It is necessary to fight the problem more skillfully. But despite this, there are several basic methods of eliminating a tumor with the help of alternative medicine.

• Recipe 1. It should take 10 grams of chopped chamomile inflorescences, althea root and juniper fruit. For a better effect, the garlic head is also used. All ingredients must be mixed together, chop the garlic. Then pour the whole with a liter of cold water and bring to a boil. Then weighed for an hour on low heat. The resulting solution is cooled and rinsed.
• Recipe 2. You need to take 100 grams of garlic juice and a couple tablespoons of walnut leaves wiped into powder. For maximum effect, nettle is also used. The resulting ingredients are mixed and 500 ml of liquid honey are added to them. The resulting mixture allows you to restore the strength of the body.
• Recipe 3. You should take the garlic and squeeze out the juice from it. The first five days should be taken 10 drops, the next 5 days for 20 drops. Thus, the dosage is brought to 2 tablespoons per day.

[21], [22], [23]

Herbal Treatment

Herbs are related to alternative medicine. To date, it is used quite often. But in the presence of serious inflammatory processes and cancerous tumors, it is not advisable to resort to its help. More precisely, it can be used only in combination with other methods.

Recipe 1. You should take 100 grams of calendula petals and fill them with half an alcohol (60 degrees). The received tincture leaves for 10 days in a dark place. Periodic contents should be shaken. After the set time, you need to drain the tincture and use one teaspoon per day. In addition, you should eat everything with 200 grams of carrot paste. Fill it with 3-5 cloves of garlic, you can add more onions.

Recipe 2. It is necessary to take the flowers of marigold and the grass of the bedstraw. To prepare the preparation, take 2 tablespoons of the collection and pour 500 ml of water. Cook everything on low heat for 5 minutes. After that, cool and drain. Take the drug should be ¼ cup to 4 times a day for 15 minutes before meals.

Homeopathy

Homeopathic remedies are also widely used, however, they are not always of particular importance. Still it is recommended to resort to traditional medicine. Despite this, the most basic homeopathic remedies will be presented below.

• Carcinosine. It is used exclusively in breeding 200 or 1000. It can be used once a week or a month. In parallel, other drugs are used.
• Conium. The tool managed to show its effectiveness. It is used exclusively in breeding 200 or 1000.
• Arsenicum. Effective with burning sensation. Kalium cyanatum is 30, 200-useful for cancer of the tongue. Especially often it is used for neuralgia of facial nerves.
• Hydra. This tincture is effective for erythroplasty of the uterus. The solution can be used for syringing. Actively used for oral lesions. It helps to relieve pain. Use it can not be more than 2 times a week.
• Carbo animalis 30-at the break of pus. Aconite Radix is used to relieve pain by 1 or 2 drops. This technique is used until the complete disappearance of the pain syndrome.
• Phosphorus. It is widely used for tumors in the oral cavity, on the lips and cheeks. The patient experiences a strong thirst and requires icy water.

There are many other drugs that are used depending on the symptoms. You can choose an effective remedy only with a homeopathic doctor.

Operative treatment

To carry out this technique, various operations can be applied. In this case, the location of the tumor, the stage of development, and the need for restorative interventions are taken into account.

In patients who have a tumor in the oral cavity, removal is performed without seizure of bone tissue. If the mobility is significantly limited, resort to the removal of the lesion along with part of the jaw. The defeat of the jaw can be seen on the roentgenogram.

If the tumor is on the lip, then a special surgical micrographic method is used. In this case, the tumor is removed by layers using a microscope. This will completely eliminate the neoplasm and keep the normal tissues of the lips.

Malignant tumors are usually "famous" for the damage to the lymph nodes located on the neck. Therefore, the removal procedure involves the removal of suspicious lymph nodes. The volume of the operation depends entirely on the spread of the tumor. Sometimes you need to remove muscles, nerves and blood vessels.

This method can lead to complications. Thus, the numbness of the ear, the lowering of the lower lip and the difficulty of lifting the arms above the head are not excluded. This is due to nerve damage. Sometimes there is difficulty breathing.

Prevention

Many cases of development of tumors in the oral cavity can be completely prevented. For this it is necessary to simply exclude known negative factors. So, tobacco and smoking are a special risk. In most cases, they lead to the development of neoplasms. After all, lips, mouth and mucous membranes are constantly exposed to the negative effects of nicotine. The best solution is getting rid of the addiction.

It is necessary to understand that smoking together with alcohol several times increase the risk of developing erythroplasty. Therefore, it is worthwhile to reconsider your own life. The risk of the problem is great. It is important to avoid being in the sun at the peak of its activity. Negative exposure to ultraviolet light can lead to lip cancer.

It is enough simply to eliminate addictive habits and start eating special foods. So, vegetables, fruits and products from coarse grains can reduce the risk of pathology several times.

Forecast

After the measures are taken to eliminate the tumor, a person may feel some problems with speech and swallowing. Eliminate all this is possible, but not yourself. You should seek help from a nutritionist and speech therapist. They will conduct a survey, listen to the patient and, based on the data obtained, will prescribe appropriate procedures.

People who have suffered a malignant neoplasm have a risk of re-development of the problem. Relapse can occur within 2 years from the date of elimination of the tumor. Therefore, patients should always be under the close supervision of doctors.

Patients undergoing radiation therapy risk to reduce the level of hormones that are produced by the thyroid gland. In order to completely get rid of the problem, it is worthwhile to seek help from an endocrinologist and take the course of the therapy prescribed by him.

It is proved that patients with cancer have a risk of repeated development of the tumor. A special risk is observed with alcohol and smoking. Therefore, it is better to get rid of these bad habits.

[24], [25], [26]