Erythroplakia is a clinical term to describe any erythematous (red) area on a mucous membrane, that cannot be attributed to any other

pathology Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in ...

. The term erythroplasia was coined by Louis Queyrat to describe a precancerous red lesion of the penis. This gave rise to the term erythoplasia of Queyrat. Depending upon the context, this term may refer specifically to carcinoma in situ of the glans penis or vulva appearing as a red patch, or may be used as a synonym of erythroplasia on other mucous membrane or transitional sites. It mainly affects the glans penis (the head of the penis), although uncommonly it may present on the mucous membranes of the

larynx The larynx (), commonly called the voice box, is an organ in the top of the neck involved in breathing, producing sound and protecting the trachea against food aspiration. The opening of larynx into pharynx known as the laryngeal inlet is about ...

, and rarely, the

mouth In animal anatomy, the mouth, also known as the oral cavity, or in Latin cavum oris, is the opening through which many animals take in food and issue vocal sounds. It is also the cavity lying at the upper end of the alimentary canal, bounded on ...

, or the anus. Erythroplakia is analogous to the term leukoplakia which describes white patches. Together, these are the 2 traditionally accepted types of premalignant lesion in the mouth, When a lesion contains both red and white areas, the term "speckled leukoplakia" or "eyrthroleukoplakia" is used. Although oral erythroplakia is much less common than leukoplakia, erythroplakia carries a significantly higher risk of containing dysplasia or carcinoma in situ, and of eventually transforming into invasive

squamous cell carcinoma Squamous-cell carcinomas (SCCs), also known as epidermoid carcinomas, comprise a number of different types of cancer that begin in squamous cells. These cells form on the surface of the skin, on the lining of hollow organs in the body, and on the ...

(a type of oral cancer).

Signs and symptoms

Although often the terms ''erythroplasia'' and ''erythroplakia'' are used synonymously, some sources distinguish them, stating that the latter is macular (flat) while the former is

papular A skin condition, also known as cutaneous condition, is any medical condition that affects the integumentary system—the organ system that encloses the Human body, body and includes skin, Nail (anatomy), nails, and related muscle and glands. Th ...

(bumpy). Erythroplakia of the genital mucosae is often referred to as

erythroplasia of Queyrat Squamous-cell skin cancer, also known as cutaneous squamous-cell carcinoma (cSCC), is one of the main types of skin cancer along with basal cell cancer and melanoma. It usually presents as a hard lump with a scaly top but can also form an ulcer. O ...

. The most common areas in the mouth where erythroplakia is found are the floor of the mouth, buccal vestibule, the

tongue The tongue is a muscular organ (anatomy), organ in the mouth of a typical tetrapod. It manipulates food for mastication and swallowing as part of the digestive system, digestive process, and is the primary organ of taste. The tongue's upper surfa ...

, and the

soft palate The soft palate (also known as the velum, palatal velum, or muscular palate) is, in mammals, the soft tissue constituting the back of the roof of the mouth. The soft palate is part of the palate of the mouth; the other part is the hard palate. ...

. It appears as a red

macule A skin condition, also known as cutaneous condition, is any medical condition that affects the integumentary system—the organ system that encloses the body and includes skin, nails, and related muscle and glands. The major function of this sy ...

or plaque with well-demarcated borders. The texture is characterized as soft and velvety. An adjacent area of leukoplakia may be found along with the erythroplakia. Erythroplasia may also occur on the laryngeal mucosa, or the anal mucosa.

Causes

Erythroplakia has an unknown cause but researchers presume it to be similar to the causes of

. Carcinoma is found in almost 40% of erythroplakia.Ridge JA, Glisson BS, Lango MN, et al
"Head and Neck Tumors"
in Pazdur R, Wagman LD, Camphausen KA, Hoskins WJ (Eds
Cancer Management: A Multidisciplinary Approach
. 11 ed. 2008. It is mostly found in elderly men around the ages of 65 - 74. It is commonly associated with

smoking Smoking is a practice in which a substance is burned and the resulting smoke is typically breathed in to be tasted and absorbed into the bloodstream. Most commonly, the substance used is the dried leaves of the tobacco plant, which have bee ...

. Alcohol and tobacco use have been described as risk factors.

Diagnosis

Differential diagnosis of an oral red lesion

There are many other conditions that are similar in appearance and must be ruled out before a

diagnosis Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engin ...

of erythroplakia is made (see table). Sometimes, a diagnosis is delayed for up to two weeks in order to see if the lesion spontaneously regresses on its own or if another cause can be found. Erythroplakia frequently is associated with dysplasia, and is thus a

precancerous A precancerous condition is a condition, tumor or lesion involving abnormal cells which are associated with an increased risk of developing into cancer. Clinically, precancerous conditions encompass a variety of abnormal tissues with an increased ...

lesion.

Biopsy

Microscopically, the tissue exhibits severe epithelial dysplasia, carcinoma-in-situ, or invasive squamous cell carcinoma in 90% of cases. There is an absence of

keratin Keratin () is one of a family of structural fibrous proteins also known as ''scleroproteins''. Alpha-keratin (α-keratin) is a type of keratin found in vertebrates. It is the key structural material making up scales, hair, nails, feathers, ho ...

production and a reduced number of

epithelial Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellula ...

cells Cell most often refers to: * Cell (biology), the functional basic unit of life Cell may also refer to: Locations * Monastic cell, a small room, hut, or cave in which a religious recluse lives, alternatively the small precursor of a monastery w ...

. Since the underlying vascular structures are less hidden by tissue, erythroplakia appears red when viewed in a clinical setting.

Treatment

Treatment involves

biopsy A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a diseas ...

of the lesion to identify extent of dysplasia. Complete excision of the lesion is sometimes advised depending on the histopathology found in the biopsy. Even in these cases, recurrence of the erythroplakia is common and, thus, long-term monitoring is needed.

History

In 1911, French dermatologist Louis Queyrat described a sharply defined, bright red, glistening velvety precancerous lesion of the glans penis. He coined the term "erythroplasie" to designate red plaques as an analogy to "leucoplasie", which designated white patches. Since "leucoplasie" was the equivalent of the English leukoplakia (coined in 1861), the term became erythroplakia in English. Similarly, the term leukoplakia was originally coined to describe white lesions of the urinary tract, and in 1877 was first applied to white patches in the mouth. It is unclear when the term erythroplakia was first adapted to describe red lesions in the mouth.

Etymology

The word erythroplakia means "red patch", and is derived from the Greek words ερυθρος - "red" and πλάξ - "plate" The

World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...

defines oral erythroplakia as follows:

References

External links

{{Oral pathology Conditions of the mucous membranes Oral mucosal pathology