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Oral leukoplakia

Leukoplakia is a common condition (<1%) of the mouth that involves the formation of white leathery spots on the mucous membranes of the tongue and inside of the mouth. It is not a specific disease entity and is diagnosed by exclusion of diseases that may cause similar white lesions like candidiasis or lichen planus. more...

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Leukoplakia is common in adults, mostly in the 50-70 years age group. The cause in most cases is unknown, but many are related to tobacco use and chronic irritation. A small proportion of cases, particularly those involving the floor of the mouth or the undersurface of the tongue is associated with a risk of cancer.

The so-called hairy leukoplakia associated with HIV infection and other diseases of severe immune deficiency does not have risks for cancer.

The treatment of leukoplakia mainly involves avoidance of predisposing factors like smoking, tobacco and betel chewing, alcohol,and removal of chronic irritants like sharp edges of teeth. In suspicious cases, a biopsy is also taken, and surgical excision done if pre-cancerous changes or frank cancer is detected.


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Novel Protease Inhibitor Shrinks Oral Leukoplakia
From Family Pratice News, 5/15/00 by Mary Ann Moon

BETHESDA, MD. -- A protease inhibitor derived from soybeans reduced the size of oral leukoplakia lesions by 24% in a 1-month phase II clinical trial, Dr. Frank L. Meyskens Jr. reported at the annual meeting of the American Society of Preventive Oncology.

The agent, a concentrate of the soybean extract known as Bowman-Birk inhibitor (BBI) will now be tested in a 6-month, randomized, blinded trial of 90 patients, said Dr. Meyskens, director of the Chao Family Comprehensive Cancer Center at the University of California, Irvine.

BBI has been found to prevent cancers in many animal systems and causes little or no toxicity. Its safety and clinical effectiveness were assessed in this dose-escalation trial involving 32 patients who had oral leukoplakia.

The patients swished in their mouths a solution containing BBI concentrate and then swallowed it. There were no signs of toxicity even at the highest doses tested, he reported.

Overall, lesion size decreased by 24% at 1-month follow-up, as judged by non-blinded clinical assessment and by blinded analysis of lesion photographs. The treatment response was dose related, Dr. Meyskens said.

In addition, samples of the subjects' buccal mucosal cells and serum were analyzed for expression of neu protein, which is known to be overexpressed in oral dysplastic lesions. A dose-dependent decrease in neu protein expression was observed and correlated with clinical improvement, he said.

COPYRIGHT 2000 International Medical News Group
COPYRIGHT 2001 Gale Group

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