The inside of the mouth is lined with a layer of mucous membrane. The oral mucosa has points in common with the skin. Skin diseases can therefore also cause symptoms in the mouth. But since the composition of the mucous membrane is different from that of the skin (there is no keratinization, for example), the skin disease may take on a different appearance in the mouth.
Most diseases are described on the basis of their appearance (blisters or bubbles, purulent lesions, color, etc.). Some are mild and go away on their own, others can be a warning sign of serious illness.
This patient guide covers the following conditions:
- leukoplakia and erythroplakia,
- lichen planus,
- lichenoid reactions,
- discoid lupus erythematosus (SLE),
- pigmentation of the oral mucosa.
Leukoplakia and erythroplakia
What is it about ?
Leukoplakia (leuco = white) and erythroplakia (erythro = red) are well-defined areas in the mouth that do not go away with scratching. Leukoplakia is usually the result of prolonged heavy use of tobacco and / or alcohol. These lesions can be the first sign of oral cancer, especially in the case of erythroplakia.
How is the diagnosis made?
The appearance of the lesions can already put the doctor on the trail of the diagnosis. A biopsy is almost always taken to confirm the diagnosis and rule out malignant transformation.
What can you do ?
The main steps are to stop smoking and limit your alcohol consumption.
What can your doctor do?
The doctor may choose to monitor the lesions closely or decide to have them removed surgically. A good follow-up is also necessary after the removal of leukoplakia.
Lichen planus
What is it about ?
the lichen planus is inflammation of the skin, but in 70% of cases it also causes lesions in the mouth. The clinical picture may vary. Lichen planus therefore comes in many forms. We do not know the exact cause. Certain viral infections and medications can contribute to this, as well as stress. The immune system is suspected to play an important role in the onset of the disease. Contact with fillings (dental amalgams), wearing a dental prosthesis and fungi (yeast infection) can worsen the disease. Lichen planus is not contagious. A small percentage of the lesions can become malignant.
What is its frequency?
Lichen planus is relatively common. Oral lesions occur in 2% of the population, mainly women. The frequency increases with age.
How to recognize it?
Lichen planus can come in many forms: it can be an area with white intersecting streaks, small spots, or papules. There is a specific form of lichen planus that affects the hair follicles, which can lead to baldness. Surprisingly, oral lesions are generally symmetrical. Lesions may also appear on the tongue and / or gums.
How is the diagnosis made?
The doctor may suspect the disease based on the appearance of the lesions in the mouth and / or on the skin. The diagnosis is often confirmed by a biopsy. To do this, the doctor takes a piece of tissue from the affected area and sends it to the laboratory.
What can you do ?
Good oral hygiene is very important. Have your teeth descaled regularly. If you wear a denture, it should fit snugly in your mouth. It is preferable to file off the sharp edges of fillings (dental amalgams).
What can your doctor do?
We can expect spontaneous healing. Treatment generally consists of cortisone preparations in the form of a spray, cream and / or mouthwash. In severe cases, it is possible to inject cortisone into the lesions. There are drugs that work on the immune system and work well. However, they have not yet entered into common use.
Lichenoid reactions
What is it about ?
A lichenoid reaction is an inflammation of the skin similar to lichen planus. It generally occurs as a reaction to taking medication (blood pressure medication, anti-inflammatory drugs, antibiotics, etc.) or contact with fillings (dental amalgams) and / or following an autoimmune disease.
What can your doctor do?
Your doctor will start by removing the trigger. Otherwise, the treatment is similar to that of lichen planus.
Discoid lupus erythematosus
What is it about ?
Discoid lupus erythematosus (SLE) is an autoimmune inflammation of the skin and / or oral mucosa. A typical feature of LED is that exposure to light can trigger a flare. SLE is a local form of lupus, in which the lesions are limited to the skin and mouth. The generalized form, which affects the joints and other organs, is known as systemic lupus erythematosus or systemic lupus (LS). Just because you have the local form does not mean that you are sure to develop the generalized form of lupus. It is estimated that 5% of people with SLE progress to the generalized form.
What is its frequency?
SLE is mostly found in young or middle-aged women. The exact figures are not known.
How to recognize it?
You will most often notice fairly well defined red skin lesions. These heal and begin to peel, possibly leaving a scar. Oral lesions are also red, but they are not as well defined as on the skin. They can be bordered by a white line. Sometimes they have small white spots in their center. The lesions look very much like canker sores, but they are usually painless. Oral lesions mainly develop on the cheek, palate and lower lip.
How is the diagnosis made?
Your doctor may suspect lupus based on how the lesions look and where they are. The diagnosis is confirmed by a biopsy.
What can you do ?
Protect yourself well from the sun, as LED is suspected to increase the risk of skin cancer, especially in the lips.
What can your doctor do?
Because SLE is an autoimmune disease, treatment focuses on inhibiting the immune system (immunosuppression).
Pigmentation of the oral mucosa
What is it about ?
Pigmentation of the oral mucosa refers to discoloration of the oral mucosa. Certain inflammatory diseases (eg lichen planus) may be the cause. But the discoloration can also be due to tobacco (or its smoke), to certain drugs or to contact with fillings (dental amalgams). Pigmentation of the oral mucosa can be a symptom of a rare disease, such as addison’s disease.
What can your doctor do?
Treatment depends entirely on the root cause of the pigmentation. Your doctor will therefore first look for the cause before initiating treatment.
Want to know more?
- Leukoplakia (image) – DermIS – Dermatology Information System
- Lichen planus (images) – DermIS – Dermatology Information System
- Discoid lupus erythematosus (image) – DermIS – Dermatology Information System
- Discoid lupus erythematosus (image) – DermIS – Dermatology Information System
- Tips for unparalleled oral hygiene – Christian Mutuality
- Stop smoking. It’s possible – Tabacstop
- Alcohol, the point on your consumption – Stop or else?
- Sun protection – Christian mutuality
Are you looking for more specialized help?
- Smoking Assistance Center (CAF®) – FARES – Respiratory Affections Fund
- Tobacco specialists – FARES – Respiratory Affections Fund
- Alcohol aid – Le Pélican & Le center ALFA
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