Leukoplakia coming back?


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Hello - back in August, I had some leukoplakia removed with CO2 laser. At my most recent follow up, mid-Oct, my ENT thought everything looked good with the healing.

Yesterday, I noticed a whitish patch next to the scar tissue. It looks like I might have just bit it and it's healing, but I can't tell. I'm going to see if my ENT will see me after the holidays, but until then, can anyone chime in whether this looks more like healing skin or leukoplakia recurring?

If I didn't directly shine light on it, it doesn't pop out as white like my previous leukoplakia did. It also feels smooth/like the skin around it, nothing raised or rough.

The pictures aren't the best. It's a difficult area to photograph.

Thanks for any help!

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honestdoc

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Could you provide August images? It looks like hyperkeratinized tissue in a high risk area. Definitely check in with your ENT.
 
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I don't have those anymore unfortunately. Back in August, it truly looked white (even without a light shining directly on it) and was visible above the skin. Is there any chance it's just healing tissue from a bite? I ask because there appears to be a minor indentation similar to what I've seen in past bites, but given everything that happened, I'm more paranoid now.

I have my follow up scheduled for end of February but will try to get in sooner.
 

MattKW

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Leukoplakia is a broad term that is not a disease on its own; it's more a description simply meaning "white plaque". They are nearly always non-cancerous unless they start showing speckles of redness. Did your ENT biopsy it?
 
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Yes - the original leukoplakia that was removed had epithelial dysplasia. The oral surgeon was quite surprised it came back as anything and then referred me to the ENT who removed the rest using CO2 laser with clear margins in August.
 

honestdoc

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Yes - the original leukoplakia that was removed had epithelial dysplasia. The oral surgeon was quite surprised it came back as anything and then referred me to the ENT who removed the rest using CO2 laser with clear margins in August.
Epithelial dysplasia (hyperkeratinized tissue) is precancer (not metastatic yet). It can be caused by constant irritation in your case possibly physical (rubbing on something rough/sharp). The mouth does not like constant irritation and will make abnormal (dysplasia) tissue to protect itself. Have your dentist examine where the sharp/rough spots are around the area and smooth/polish it down. Avoid any alcohol, tobacco, mouth rinses and/or anything to chemically irritate it.
 
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Thanks. I've never been a smoker/ user of tobacco products and only a light drinker, quite young too (33). I'll have by ENT examine the area further.

Just wondering how certain you are that this looks like hyperkeratosis vs. healing skin/tongue bite? If it's hyperkeratanized, should I be able to feel it?

Definitely not thrilled if it's coming back, especially given it wasn't there ~2 months ago at my follow up.
 

honestdoc

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We can't tell. I suspect that side of the tongue has been desensitized. Have your dentist check for any rough/sharp areas and smooth/polish it.
 
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Will do! My molar looks like it may be a bit sharp and it roughly lines up where that white patch is, so maybe that's it. Hopefully it's just that or healing and nothing more sinister.

Happy holidays and Thank you!
 

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