Oral Mukozadaki Beyaz Lezyonlar
Özet
Oral beyaz lezyonlar, klinik olarak tanı koyulması güç ancak diş hekimliği pratiğinde sık karşılaşılan lezyonlar arasında yer alır. Bu lezyonlar, benign reaktif süreçlerden malign potansiyele sahip prekanseröz ve karsinomatöz lezyonlara kadar geniş bir yelpazeye sahiptir. Klinik özellikler, hasta anamnezi ve histopatolojik incelemeler, doğru tanı ve uygun tedavi planı için kritik öneme sahiptir. Beyaz lezyonlar genellikle keratin tabakasının kalınlaşması, mantar enfeksiyonları veya kimyasal iritanların birikmesiyle ilişkilidir. Lökoplaki, liken planus, tüylü lökoplaki gibi lezyonlar malign dönüşüm riski taşıyabilirken, linea alba veya lökoödem gibi bazıları zararsızdır. Lezyonların sınıflandırılmasında yüzeyden kazınıp kazınamaması, renk değişiklikleri ve klinik semptomlar belirleyicidir. Oral beyaz lezyonların erken teşhisi, premalign lezyonların malign dönüşüm riskini azaltarak tedavi başarısını artırır. Bu çalışmada, oral beyaz lezyonların etiyolojisi, klinik özellikleri ve tedavi yaklaşımları ele alınmıştır.
Oral white lesions are clinically challenging to diagnose but are frequently encountered in dental practice. These lesions range from benign reactive processes to potentially malignant and carcinomatous lesions. Accurate diagnosis and appropriate treatment planning rely on clinical features, patient history, and histopathological evaluations. White lesions often result from keratin layer thickening, fungal infections, or the accumulation of chemical irritants. Lesions such as leukoplakia, lichen planus, and hairy leukoplakia carry a risk of malignant transformation, whereas others, such as linea alba or leukoedema, are benign. The classification of these lesions is based on factors such as whether the lesion can be scraped off, changes in color, and clinical symptoms. Early diagnosis of oral white lesions is critical, as it reduces the risk of malignant transformation in premalignant lesions, thereby improving treatment outcomes. This study discusses the etiology, clinical characteristics, and management approaches of oral white lesions.
Referanslar
Oygür T. Ağız lezyonları ve temel patogenetik mekanizmalar. Ağız patolojisi ders kitabı. Ankara: Efil Yayınevi; 2010.
Eısenberg E. Alterations in Color: Oral White, Red, and Brown Lesions. In: Dental Science for the Medical Professional: An Evidence-Based Approach. Cham: Springer International Publishing, 2023. 201-241.
García MS, Teruya-Feldstein J. The diagnosis and treatment of dyskeratosis congenita: A review. J Blood Med. 2014;5:157.
Babu NA, Rajesh E, Krupaa J, Gnananandar G. Genodermatoses. J Pharm Bioallied Sci. 2015;7:S203–S206.
Dar-Odeh NS, Shehabi AA. Oral candidosis in patients with removable dentures. Mycoses. 2003;46(5-6):187-91.
Borle RM, Borle SR. Management of oral submucous fibrosis: A conservative approach. J Oral Maxillofac Surg. 1991;49(8):788–91.
Rafat Z, Sasani E, Salimi Y, Hajimohammadi S, Shenagari M, Roostaei D. The prevalence, etiological agents, clinical features, treatment, and diagnosis of HIV-associated oral candidiasis in pediatrics across the world: a systematic review and meta-analysis. Frontiers Pediatrics. 2021;9, 805527-45.
Hagiwara Y, Seki K, Takahashi Y. Oral chemical burn due to accidental ingestion of calcium oxide food desiccant in a patient with dementia. J Int Med Res. 2020; 48(4),0300060520920065.
Günhan Ö. Oral ve Maksillofasiyal Patoloji. Ankara: 2001. s. 59-85.
Haseth SB, Bakker E, Vermeer MH, et al. A novel keratin 13 variant in a four-generation family with White sponge nevus. Clin Case Rep. 2017;5:1503–1509.
Karakuzu A, Özçelik S. Oral mukozanın bakteriyel enfeksiyonları. Turkiye Klinikleri Journal of Dermatology Special Topics. 2015;8(4):29-34.
Kasapçopur Ö, Arısoy N. Ergenlik çağında bağ dokusu hastalıkları. Türk Pediatri Arşivi. 2011;46(11).
Weidner N, Cote RJ, Suster S, Weiss LM. Modern surgical pathology. Second ed. Saunders: Elsevier Inc.; 2009.
Khanna JN, Andrade NN. Oral submucous fibrosis: a new concept in surgical management. Report of 100 cases. Int J Oral Maxillofac Surg. 1995;24(6):433–9.
Sharon V, Fazel N. Oral candidiasis and angular cheilitis. Dermatologic Therapy. 2010;23(3):230-42.
Van Heerden W. Oral manifestations of viral infections. South African Family Practice. 2006;48(8):20-4.
Rajendran R. Oral submucous fibrosis: etiology, pathogenesis, and future research. Bull World Health Organ. 1994;72(6):985–96.
Le PV, Gornitsky M, Domanowski G. Oral stent as treatment adjunct for oral submucous fibrosis. Oral Surg Oral Med Oral Pathol. 1996;81(2):148–50.
Gupta S, Jawanda MK. Oral submucous fibrosis: An overview of a challenging entity. Indian J Derma Venereo Lepro. 2021;87(6),768-777.
Mohammad A, Bobby J, Devipriya S. Prevalence of oral mucosal lesions in patients of the Kuwait University Dental Center. Saudi Dent J. 2013;25:111–118.
Mortazavi H, Safi Y, Baharvand M, et al. Peripheral Exophytic Oral Lesions: A Clinical Decision Tree. Int J Dent. 2017;2017:9193831.
Naganawa T, Murozumi H, Kumar A, et al. Intraoral chemical burn in an elderly patient with dementia. Int J Burn Trauma. 2015;5:79.
O’brien M. Children’s Dental Health in the United Kingdom 1993 Report of Dental Survey. First ed. London: Her Majesty’s Stationery Office; 1994.
Shields CL, Shields JA, Eagle RC Jr. Hereditary benign intraepithelial dyskeratosis. Arch Ophthalmol. 1987;105(3):422–3.
Reamy B, Derby R, Bunt C. Common tongue conditions in primary care. Am Fam Physician. 2010;81(5):627-34.
Mallick S, Benson R, Rath G. Radiation induced oral mucositis: a review of current literature on prevention and management. European Archives of Oto-Rhino-Laryngology. 2016;273(9):2285-93.
Abe M, Sogabe Y, Syuto T, Ishibuchi H, Yokoyama Y, Ishikawa O. Successful treatment with cyclosporin administration for persistent benign migratory glossitis. The Journal of Dermatology. 2007;34(5):340-3.
Drage L, Rogers R. Burning mouth syndrome. Dermatologic Clinics. 2003;21(1):135-45.
Pinheiro Rdos S, de Franca T, Ferreira Dde C, et al. Human papillomavirus in the oral cavity of children. J Oral Pathol Med. 2011;40(2):121-6.
Black MM. Lichen planus and lichenoid eruptions. In: Rook A, Wilkinson DS, Ebling FJG, et al, editors. Textbook of dermatology. 4th ed. Boston: Blackwell; 1986.
de Arruda JAA, Monteiro JLGC, Barreto MEZ, Villarroel-Dorrego M, Gilligan G, Panico R, de Andrade BAB. Uremic Stomatitis: A Latin American Case Series and Literature Review. Head Neck Pathol. 2024;18(1), 54.
Faccın KM, Sandını V, Junıor DH, Pılatı PVF, Pılatı SFM. Contact Stomatıtıs By Artıfıcıal Cınnamon Flavors. Oral Surg Oral Med Oral Pathol Oral Radiol. 2024;137(6), e161.
Arora PC, Arora A, Arora, S. White oral lesions of morsicatio linguarum. Indian J Derma. 2022;67(6),756-759.
Vieira RA, Minicucci EM, Marques ME, Marques SA. Actinic cheilitis and squamous cell carcinoma of the lip: Clinical, histopathological and immunogenetic aspects. Anais Brasileiros de Dermatologia. 2012;87:105–114.
