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Old 03-12-2012
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Question What is the cause of this tongue lesion?

A 60 year old man has the lesion as shown in the image. What is the greatest risk factor for developing this lesion?
A. Excessive consumption of alcohol
B. Cigarette smoking
C. glossitis due to Candida Albicans
D. glossitis due to EBV
E. glossitis due to vitamin B12 deficiency.

What is the cause of this tongue lesion?-tongue-lesion.jpg
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Old 03-12-2012
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Leukoplakia-excessive alcohol consumption.
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Old 03-12-2012
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smoking... Leukoplakia
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"Disease is very old, and nothing about it has changed. It is we who change as we learn to recognize what was formerly imperceptible." JMC
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Quote:
Originally Posted by vna.rao22 View Post
Leukoplakia-excessive alcohol consumption.
However, according to Goljan P. 319 3th edition:

"Leukoplakia and erythroplakia

Leukoplakia literally means "white patch" (Fig. 17-5).
It has an ∼30% rate of progression to oral cancer.
Erythroplakia is a red patch (Fig. 17-6).
It has an ∼60% rate of progression to oral cancer.
Lesion does not wipe off.
Both lesions are due to squamous hyperplasia of the epidermis.
Increased risk for squamous dysplasia or invasive squamous cancer
Causes
Chronic irritation (e.g., dentures)
Leukoplakia/erythroplakia: smoking and alcohol are major risk
factors
All forms of tobacco use
Alcohol abuse
Human papillomavirus (HPV)

Locations
Vermilion border lower lip (most common site)
Buccal mucosa
Hard and soft palates

Leukoplakia/erythroplakia: biopsy to rule out squamous dysplasia or cancer

Floor of the mouth"

So... it could be smoking, alcohol or EBV.... Where do we stand here?
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Old 03-12-2012
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Thumbs Up leukoplakia...you are right!

@Dr Mexito, your first choice is always correct (as far as I remember about my Qs); however your second thought is ...lol

@Vna.rao22: Alcohol consumption is the second greatest risk.The oral cavity usually gets the first exposure to nicotine.

I just want to share with you guys the picture of leucoplakia which I find interesting.

Here is the answer:
The photograph shows discrete raised white patches (leukoplakia) on both sides of the tongue. The lesions on the left side of the tongue appear to be displacing the midline of the tongue to the right and are due to an invasive squamous cell carcinoma. The right side of the tongue shows a leukoplakic patch on the right border of the tongue posteriorly. A biopsy of the lesion showed squamous dysplasia, a precursor lesion for squamous cell cancer. This observation underscores the necessity for performing a biopsy of leukoplakic lesions in the oral cavity to distinguish benign epithelial lesions from precancerous or cancerous lesions. Cigarette smoking is the greatest risk factor for squamous cell cancer in the mouth and oropharynx. Pipe smoking and smokeless tobacco are also risk factors.

Cheer!
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Clinical-Signs, Figures-, Gastrointestinal-Tract-, Pathology-, Step-1-Questions

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