Derm: Leukoplakia: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Leukoplakia🎧 A focused deep dive into this potentially pre-malignant white oral lesion – essential for MSRA revision and real-world clinical practice.🧠 Key Learning Points📌 DefinitionLeukoplakia is a white, thickened patch in the mouth that cannot be scraped off. It is a diagnosis of exclusion and considered potentially pre-cancerous, most often found on the buccal mucosa, tongue, or floor of mouth.📌 Causes & Risk Factors• Tobacco use (smoking/chewing) – most significant factor• Chronic mechanical irritation (e.g. sharp teeth, dentures, cheek biting)• Alcohol use (especially with tobacco – synergistic effect)• HPV infection• Poor oral hygiene• Older age, male gender🧠 Mnemonic: TAP-ITT – Tobacco / TraumaA – AlcoholP – Poor hygiene / Prolonged irritation / HPVI – In malesT – Typically in older adults📌 Pathophysiology• Chronic irritation triggers epithelial cell changes• Leads to abnormal keratinisation and thickening• Can result in dysplasia – precancerous cell changes• Dysplasia increases risk of transformation to oral squamous cell carcinoma📌 Symptoms• White or greyish plaque-like lesion• Can be smooth, rough, speckled, or warty (verrucous)• Typically painless and non-scrapable• May cause irritation, soreness or burning• Common sites: cheeks (buccal mucosa), tongue (sides/undersurface), floor of mouth📌 Red Flag Features for Malignant Risk• Speckled or verrucous appearance• Ulceration or erosion within lesion• Induration (firmness/hardening)• Presence of a nodule• High-risk sites: floor of mouth, underside of tongue🧠 These features warrant urgent biopsy and specialist referral📌 Differential Diagnosis• Oral candidiasis (scrapes off)• Oral lichen planus (lace-like pattern)• Chemical burns• White sponge nevus• Lupus, psoriasis, syphilis📌 Diagnosis• Clinical history + examination• Biopsy is essential – to confirm diagnosis and assess for dysplasia• Histology reveals: mild, moderate, severe dysplasia, carcinoma in situ, or cancer📌 Management• Eliminate risk factors – smoking cessation, alcohol reduction• Treat contributing factors – sharp teeth, ill-fitting dentures• Surveillance – regular follow-up for lesion changes• Repeat biopsies if lesion evolves• Treatment (if required):– Surgical excision– Laser therapy– Cryotherapy– Topical agents like retinoids (limited role)• Specialist referral to oral medicine/maxillofacial teams essential❗ Note: No universal treatment consensus. Even excised lesions can recur or progress.📌 Prognosis & Complications• Most lesions remain stable or regress• 1–9% may develop into oral squamous cell carcinoma• Higher risk with:– Non-homogenous lesions– Presence of dysplasia– Lesions on floor of mouth or tongue– Continued smoking• Other complications: local irritation, discomfort, psychological stress📎 More MSRA Resources for Leukoplakia📝 Revision Notes:https://www.passthemsra.com/topic/leukoplakia-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/leukoplakia-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/leukoplakia-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/leukoplakia-rapid-quiz/🧪 Topic Quiz:https://www.passthemsra.com/quizzes/leukoplakia/🎓 Full Dermatology Course:https://www.passthemsra.com/courses/dermatology-for-the-msra/📣 All resources part of the Dermatology for the MSRA course at👉 https://www.passthemsra.comHashtags#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQandANotes #MSRAAccordions #MultiSpecialtyRecruitmentAssessment #MSRAOnlineRevision #Leukoplakia #OralPathology #Dermatology #PassTheMSRA