Erythroplakia

Erythroplakia is a bright red patch or plaque, due to de-epithelization of the superficial layers of the mucosa; the latter permit the underlying vascular bed to breathe.  It could be mixed to withish lesions (erythroplakia). It is soft and velvety in texture, flat or slightly depressed, asymptomatic, and it cannot be connected to any type of odonto-stomatological lesion. Erythroplakia is always associated with dysplasia to a varying degree and is, therefore, considered a potentially ‘obligatory’, malignant lesion at high risk of neoplastic development. Indeed, often at the moment of diagnosis a carcinoma in situ is already present. Erythroplakia can also be associated with leukoplakia and, in this case, the prognosis of the latter worsens (erythroleukoplakia, speckled leukoplakia). The presence of erythroplakia markedly correlates with an excessive consumption of alcohol and smoking and it is more common in males, especially above 60 years of age. The most common sites are the soft palate, the floor of the oral cavity and the underside of the tongue. All suspect lesions which do not heal 2 weeks after the removal of potential causal factors must always be subject to biopsy and thereafter a histo-cytopathological examination. When the latter is positive, the lesion must be totally removed surgically and the site of the lesion periodically examined.