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Leukoplakia is, therefore, the most common premalignant lesion that occurs in the mouth. [41] Leukoplakia is more common in middle-aged and elderly males. [30] The prevalence increases with increasing age. [2] In areas of the world where smokeless tobacco use is common, there is a higher prevalence. [2]
Teeth should be clean with no decay, white with shiny enamel and smooth surfaces and edges. Adults should have a total of 32 teeth (16 teeth in each arch). By the age of 2 + 1 ⁄ 2, children have a total of 20 deciduous teeth (10 in each arch). Abnormal findings are missing, loose, broken and misaligned teeth.
Hairy leukoplakia is a white patch on the side of the tongue with a corrugated or hairy appearance. It is caused by Epstein-Barr virus (EBV) and occurs usually in persons who are immunocompromised , especially those with human immunodeficiency virus infection/ acquired immunodeficiency syndrome (HIV/AIDS).
Within the latter type, the hairs occur in structures called pilosebaceous units, each with hair follicle, sebaceous gland, and associated arrector pili muscle. [4] In the embryo , the epidermis, hair, and glands form from the ectoderm , which is chemically influenced by the underlying mesoderm that forms the dermis and subcutaneous tissues.
Diagnosis is mainly clinical, based on the history and clinical appearance. The differential diagnosis includes other oral white lesions such as Leukoplakia, squamous cell carcinoma, oral candidiasis, lichen planus, white sponge nevus and contact stomatitis. [7] In contrast to pseudomembraneous candidiasis, this white patch cannot be wiped off. [7]
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Erythroplakia is analogous to the term leukoplakia which describes white patches. Together, these are the 2 traditionally accepted types of premalignant lesion in the mouth, [9] [10] When a lesion contains both red and white areas, the term "speckled leukoplakia" or "eyrthroleukoplakia" is used.
This age barrier may change soon. On Wednesday, a panel with the Centers for Disease Control and Prevention voted to lower the recommended age for older adults to get their first pneumococcal vaccine.