Precancerous lesions

Detection of lesions in such stage is the most important thing!

Look attentively for whitish / reddish lesions.

The Acupuncturist does not need to know lesion nomenclature. They should, however, carefully examine the mouth and if lesions of this type are found, refer the patient urgently to the appropriate health service.

Check the images carefully to become familiarized with the appearance of the commonest precancerous lesions and learn how to recognize them during inspection.

Be attentive!

Erythroplakia

Erythroplakia

Erythroplakia. Note the red patch on the right buccal mucosa with white areas posteriorly.

Erythroplakia

Erythroplakia

Erythroplakia. Note the red velvety lesion involving the posterior aspect of the right side of the hard palate. Note the raised irregular area along the anterolateral aspect of the lesion which is clinically suspicious of malignant transformation.

Leukoplakia

Leukoplakia

Homogeneous leukoplakia on the right buccal mucosa.

Leukoplakia

Leukoplakia

Nodular leukoplakia on the right buccal mucosa. A well-circumscribed lesion of 3x1 cm size on the right buccal mucosa in a 63-year-old habitual betel quid chewing female. Note the pin head sized nodules scattered on an erythematous base.

Leukoplakia and Candidiasis

Leukoplakia and Candidiasis

Figure A: Superadded candidiasis in a patient with homogeneous leukoplakia.
Figure B: The same patient after three weeks of antifungal treatment.

Leukoplakia

Leukoplakia

Proliferative verrucous leukoplakia (PVL). Note the extensive, thick, white plaques.

Lichen planus

Lichen planus

Lichen planus. Note the white 4x3.5 cm patch on the right side of the dorsum tongue intermingled with areas of pigmentation. Another annular form of lichen planus can be seen on the left side of the dorsum tongue.

Lichen planus

Lichen planus

Annular lichen planus. Note the ring-like pattern on the right buccal mucosa, retromolar trigone and hard palate.

Lichen planus

Lichen planus

Erosive lichen planus on the ventral surface of the tongue, just above the lingual frenum, surrounded by white striae.

Oral submucous fibrosis

Oral submucous fibrosis

Oral submucous fibrosis. Note the blanching on the lower labial mucosa.

Oral submucous fibrosis

Oral submucous fibrosis

Oral submucous fibrosis with erythroplakia of the tongue.

Lupus erythematosus

Lupus erythematosus

Figure A: Extra oral photograph of a patient with discoid lupus erythematosus. Note the butterfly-shaped rash on the malar area.
Figure B: Intraoral photograph of the same patient showing erosive lesions surrounded by radiating white striae on the left buccal mucosa.

Sideropenic dysphagia

Sideropenic dysphagia

Sideropenic dysphagia. Iron deficiency anaemia with depapillated tongue, depigmentation of the upper lip and epithelial erosion of the lower lip.

Actinic Cheiloses

Actinic Cheiloses

Actinic Cheiloses. Note the actinic keratosis affecting the lip vermilion. Usually happens as a result of too much sun exposure.

Nevus

Nevus

Observe the presence of pigmented lesion of recent growth, irregular margins, and variable color. The presence of ulceration and satellite lesions raise the possibility of melanoma.

Oral submucous fibrosis

Oral submucous fibrosis

Oral submucous fibrosis with malignant growth on the left side of the anterior part of the oral tongue.

Leukoplakia

Leukoplakia

Homogeneous leukoplakia on the dorsum and left lateral margin of the tongue, showing malignant transformation. Note the raised, erythematous posterior margin of the white plaque (arrows). Well-differentiated squamous cell carcinoma was established on histopathological examination.

Oral submucous fibrosis

Oral submucous fibrosis

Oral submucous fibrosis with a nodular, proliferative growth on the anterior aspect of the dorsum of the tongue. Well differentiated squamous cell carcinoma was established on histopathological examination.

If lesions of this type are found, refer the patient urgently to the appropriate health service.


Learn how to identify anatomic variations and oral lesions