Erythroplakia: Causes, Symptoms, Treatment and Cost

Erythroplakia is a red patch that appears on the mucous membranes of the mouth, usually on the inner cheeks or tongue. It is a precancerous condition, which means that if left untreated, it might progress to cancer. Erythroplakia is most commonly found in older adults and smokers, but can occur in anyone.

There are two types of erythroplakia: primary and secondary.

• Primary Erythroplakia:

Primary erythroplakia is a type of erythroplakia that has no known cause. It is usually found on the tongue, but it can also occur in other areas of the mouth or throat. Primary erythroplakia lesions often have irregular shapes and borders and may be raised or flat.

They may be covered with white patches or a thick coating of mucous membrane cells called squamous epithelium. Primary erythroplakia lesions are more likely to become cancerous than secondary erythroplakia lesions, so they should be monitored closely by a doctor if they do not go away on their own within several weeks to months.

• Secondary Erythroplakia:

Secondary erythroplakia is a type of erythroplakia that has an identifiable cause such as smoking, alcohol use, chronic irritation from dentures or braces, chronic acid reflux (GERD), or infection with human papillomavirus (HPV).

Secondary erythroplakia lesions may also have irregular shapes and borders, but they tend to be smaller than primary lesions and may have a smooth surface with no white patches present. Secondary lesions are less likely to become cancerous than primary ones but should still be monitored closely by a doctor if they do not go away on their own within several weeks to months.

• Erythroplakia is usually caused by chronic irritation or infection.
• It is often brought on by bad oral hygiene, smoking, consuming alcohol, and chewing tobacco.
• Other factors include viral infections including human papillomavirus (HPV), herpes simplex virus type 1 (HSV-1), and Candida albicans (a type of fungus).
• Certain medications can also cause erythroplakia, such as chemotherapy drugs used to treat cancer or immunosuppressants used to treat autoimmune diseases.

• Erythroplakia is a condition characterized by red, velvety patches on the mucous membranes of the mouth and throat.
• These patches may be slightly raised or flat and may bleed easily when scraped.
• Pain, a burning feeling, trouble swallowing, and a lump in the throat are some of the other symptoms.
• In some cases, white patches may also appear alongside the red patches.

• Avoid smoking and using other tobacco products.
• Limit alcohol consumption.
• Maintain good oral hygiene by brushing and flossing daily.
• Go to the dentist on a frequent basis for examinations and cleanings.
• Avoid oral sex or use a barrier protection such as a condom or dental dam during oral sex to reduce the risk of HPV infection, which can cause Erythroplakia.
• To preserve overall health and wellbeing, including oral health, eat a nutritious diet filled with fruits and vegetables.

Diagnosis of erythroplakia is usually done with the following methods:

• Oral examination: During an oral examination, a doctor will inspect the inside of the mouth for any abnormal changes in the lining of the mouth. If erythroplakia is present, it will appear as a red patch on the inside of the mouth.
• Biopsy: A biopsy of erythroplakia involves taking a sample of tissue from the afflicted region and sending it to a lab for analysis. To check for aberrant cells that could point to cancer or other disorders, the sample is inspected under a microscope.
• Endoscopy: Endoscopy, a technique that employs a thin, flexible tube with a small camera attached to it to see inside the body, is often used to detect erythroplakia. During an endoscopy, a doctor may take biopsies of any suspicious areas to test for cancerous cells.
• Blood tests: If a doctor suspects that an underlying condition may be causing erythroplakia, they may order blood tests to check for signs of infection or other medical issues. Other illnesses that can cause identical symptoms can be ruled out with the help of blood testing.

• Erythroplakia may cause oral cancer, which is severe and challenging to cure.
• It may also cause pain and discomfort in the mouth, as well as difficulty eating and speaking.
• In some cases, it can lead to an increased risk of infection due to the presence of bacteria or fungi in the affected area.
• Additionally, it may cause scarring of the affected area, which can impede normal functioning of the mouth and tongue.

• Gargle with warm salt water: This helps reduce inflammation and can help to prevent infections.
• Apply a paste of turmeric powder and honey: This helps to reduce inflammation and can help to heal the affected area.
• Drink ginger tea: Because of its anti-inflammatory qualities, ginger may help to lessen the effects of erythroplakia.
• Consume aloe vera juice: Aloe vera is useful for treating erythroplakia because of its anti-inflammatory and therapeutic characteristics.
• Apply coconut oil: Coconut oil has antibacterial, antifungal, antiviral, and anti-inflammatory qualities that may help in relieving the symptoms of erythroplakia.

• Soft fruits and vegetables: Soft fruits such as apples, bananas, pears, and peaches can be easier to chew and swallow. Cooked carrots, squash, and sweet potatoes are all excellent alternatives.
• Lean proteins: Lean proteins such as fish, poultry, eggs, beans, tofu, and yogurt can help provide essential nutrients without irritating the mouth.
• Dairy products: Dairy products such as cottage cheese or yogurt can provide important calcium and other vitamins for those with erythroplakia.
• High-fiber foods: High-fiber foods like whole grains (e.g., oats), legumes (e.g., lentils), nuts (e.g., almonds), seeds (e.g., flaxseeds), fruits (e.g., raspberries), and vegetables (e.g., broccoli) can help promote digestive health while providing essential nutrients for those with erythroplakia .
• Smoothies: Smoothies made from soft fruits or vegetables blended with dairy or non-dairy milk can be a great way to get extra nutrition into your diet without irritating the mouth too much.

• Avoid processed and high-sugar foods, as they can cause inflammation and worsen symptoms.
• Limit consumption of red meat, as it contains compounds that can irritate the mouth.
• Spicy meals should be avoided since they might create stinging or burning feeling in the mouth.
• Minimize the consumption of acidic foods and drinks, like citrus fruits and juices, which may irritate the mouth.
• Avoid alcohol and tobacco products, as these are known to worsen symptoms of Erythroplakia.

Treatment options may include:

• Topical medications: Topical medications for erythroplakia such as antifungal medications and topical steroids can help reduce inflammation and pain associated with the condition.
• Cryotherapy: Cryotherapy is a treatment option for erythroplakia, which involves freezing the affected area using liquid nitrogen. This method is used to destroy abnormal cells and reduce the risk of cancerous changes. The treatment typically takes about 10 minutes, and it may need to be repeated every few months to ensure that all abnormal cells are destroyed.
• Laser therapy: Laser therapy is a treatment option for erythroplakia that uses an intense beam of light to remove the abnormal cells. The laser beam destroys the abnormal cells while leaving healthy tissue unharmed.
• Excisional biopsy: This is the most common surgical treatment for erythroplakia, and involves surgically removing the affected area of tissue under local or general anesthetic.
• Electrodesiccation: This procedure uses an electric current to destroy the affected cells, and is usually reserved for larger areas of erythroplakia that cannot be treated with other methods.

A doctor specializing in oral health, such as a dentist or an oral surgeon, should be consulted for erythroplakia. The doctor will likely conduct an exam of the mouth and throat to check for any signs or symptoms of the condition.

• Topical corticosteroids: These are used to reduce inflammation and help heal the lesions. Examples include hydrocortisone, mometasone and triamcinolone.
• Antifungal medications: These can be used to treat any underlying fungal infection that may be causing the Erythroplakia. Common antifungal medications are Fluconazole, Itraconazole, and Terbinafine.
• Antibiotics: These can help to reduce any bacterial infection that may be contributing to the condition. Examples are erythromycin, tetracycline, and amoxicillin.
• Retinoids: These are topical medications that can help to reduce cell growth in the affected area and reduce inflammation.

Depending on the seriousness of the ailment, recovering from erythroplakia may take anywhere between a few weeks and several months. Additionally, lifestyle changes such as quitting smoking, reducing alcohol consumption, and maintaining good oral hygiene can help speed up recovery.

Treatments like topical or oral medicines, cryotherapy, or laser therapy may, in general, lessen symptoms and enhance the look of the impacted region.

On the other hand, these treatments may not be permanent in every instance; in order to maintain the outcomes, you might need to have them done on a regular basis. Additionally, it is important to note that some types of erythroplakia may not respond to treatment at all and will require ongoing monitoring by a doctor.

Post-treatment guidelines for erythroplakia vary depending on the severity of the condition, but generally include:

• Regular follow-up visits with a healthcare professional to monitor for recurrence.
• Regular self-examination of the affected area to monitor for any changes in size, shape, or color.
• Eliminating any irritants or trauma to the region, such as smoking and alcohol intake.
• Maintaining a healthy lifestyle by eating a balanced diet and exercising regularly.
• Taking medications as prescribed by your doctor to reduce inflammation and prevent infection.

• The cost of treatment for Erythroplakia in India depends on the type of treatment required and the severity of the condition.
• Generally, treatments such as cryotherapy, topical medications, laser therapy, and surgical excision can range from Rs 5,000 to Rs 1 lakh.
• The cost may also include hospitalization charges and other associated costs.

• Treatments for erythroplakia can cause pain, inflammation, and redness at the treatment site.
• Other potential side effects may include scarring, infection, and discoloration of the treated area.
• Some treatments may also cause changes in taste or smell and temporary hair loss in the area around the treatment site.
• More severe side effects, such organ failure or allergic responses, may sometimes happen.

If you are suffering from any complications relating to erythroplakia then you should consult a doctor nearby as they can cause complications like oral cancer, infection, scarring, etc. in which treatment course can range from a few months to years depending on the severity of the situation.