概述

黏膜白斑会导致牙龈、脸颊内侧、口腔底部,有时还会在舌头上形成增厚的白色斑块。这些斑块刮除不掉。

医生还不清楚导致黏膜白斑的原因,但认为烟草引起的慢性刺激(无论是吸烟、浸泡还是咀嚼)是白斑形成的主要原因。

大多数黏膜白斑并不会癌变(良性),但也有一些会显现出癌变的早期迹象。口腔底部的癌症可能发生在黏膜白斑附近。白色区域与红色区域混合(斑点黏膜白斑)可能提示癌变的可能性。因此,如果您的口腔出现异常的持续变化,最好去看牙医或初级保健专家。

毛状黏膜白斑有时也叫口腔毛状黏膜白斑,主要影响那些因疾病(特别是 HIV/AIDS)而导致免疫系统减弱的人群。

症状

黏膜白斑通常发生在牙龈、脸颊内侧、口腔底部(舌头下方),有时也会在舌头上形成白斑。白斑通常不会造成疼痛,而且可能一段时间内都注意不到。

黏膜白斑可能会表现为:

  • 无法清除的白色或浅灰色斑块
  • 不规则或扁平的纹理
  • 局部增厚或硬化
  • 伴随着隆起的红色病变(颗粒状黏膜白斑或黏膜红斑病)出现,这更有可能提示癌前病变

毛状黏膜白斑

毛状黏膜白斑通常出现在舌头两侧,导致毛茸茸的白色斑块出现,看起来像褶皱或突脊。它经常被误认为是鹅口疮,症状是可以清除的乳白色斑块,免疫系统弱的人常患。

何时就医

虽然黏膜白斑通常不会引起不适,但有时它可能预示着更严重的疾病。

如果您有以下任何症状,请去看牙医或主诊专家:

  • 口腔内的白斑或溃疡在两周内不能自行愈合
  • 口腔内出现肿块或白色、红色或深色斑块
  • 口腔组织持续发生变化
  • 吞咽时耳部疼痛
  • 张开下巴的能力逐渐减弱

Hairy leukoplakia

Hairy leukoplakia causes fuzzy, white patches that look like folds or ridges. The patches usually form on the sides of the tongue. Hairy leukoplakia is often mistaken as oral thrush, an infection that causes creamy white patches that can be wiped away. Oral thrush also is common in people with weak immune systems.

When to see a doctor

Even though leukoplakia does not usually cause discomfort, sometimes it can suggest a more serious condition.

See your doctor or other healthcare professional if you have any of these:

  • White patches or sores in the mouth that do not heal on their own within two weeks.
  • Lumps in the mouth.
  • White, red or dark patches in the mouth.
  • Changes in the inside of the mouth that do not go away.
  • Ear pain.
  • Problems swallowing.
  • Problems opening the jaw.

病因

虽然黏膜白斑的病因未知,但烟草使用(比如抽烟和嚼烟)等慢性刺激似乎是多数病例的病因。经常使用无烟烟草产品的人最终在使用烟草的脸颊部位形成黏膜白斑。

其他原因可能包括以下慢性刺激:

  • 锯齿状、断裂或尖锐的牙齿摩擦舌头表面
  • 断裂或不合适的假牙
  • 长期饮酒

您的牙医会与您讨论形成黏膜白斑的原因。

黏膜白斑

黏膜白斑由感染 EB 病毒导致。一旦您感染人类孢疹病毒第四型,病毒会终生留在您体内。正常来说,这个病毒会休眠,但如果您的免疫系统低下,特别是感染 HIV/AIDS,这个病毒就会重新激活,导致毛状黏膜白斑等疾病。

Hairy leukoplakia

Hairy leukoplakia results from infection with the Epstein-Barr virus (EBV). Once you've been infected with EBV, the virus remains in your body for life. Usually the virus is not active and does not cause symptoms. But if your immune system is weakened, especially from HIV/AIDS, the virus can become active. This can lead to conditions such as hairy leukoplakia.

风险因素

烟草使用(特别是无烟烟草)将增加您患黏膜白斑和口腔癌的风险。长期饮酒会增加风险,而既吸烟又饮酒则会进一步增加风险。

毛状黏膜白斑

HIV/AIDS 患者尤其容易患上毛状黏膜白斑。尽管使用抗逆转录病毒药物减少了病例数,但毛状黏膜白斑仍影响着许多 HIV 阳性人群,毛状黏膜白斑可能是 HIV 感染的最早迹象之一。

Hairy leukoplakia

People with HIV/AIDS are especially likely to develop hairy leukoplakia. The use of medicines that slow down or prevent HIV activity has reduced the number of people who get hairy leukoplakia. But it still affects many people who are HIV positive. It may be one of the early signs of HIV infection.

并发症

黏膜白斑通常不会对口腔组织造成永久性损伤。然而,黏膜白斑会增加患口腔癌的风险。口腔癌通常在黏膜白斑斑块附近形成,而这些斑块本身也可能发生癌变。即使去除了黏膜白斑斑块,口腔癌的风险仍然存在。

毛状黏膜白斑

毛状黏膜白斑不太可能导致癌症。但可能指示艾滋病毒/艾滋病。

Hairy leukoplakia

Hairy leukoplakia is not likely to lead to cancer. But it may be an early symptom of HIV/AIDS.

预防

如果您能够避免使用所有的烟草制品或酒精,则可以预防黏膜白斑。与医生讨论帮助您戒烟的方法。如果您继续吸烟或咀嚼烟草或饮酒,则要经常检查牙齿。口腔癌通常是无痛的,直到相当晚期,所以戒烟和戒酒是更好的预防策略。

毛状黏膜白斑

如果您的免疫系统减弱,则可能无法预防毛状黏膜白斑,但及早发现可以帮助您获得适当的治疗。

Hairy leukoplakia

If you have a weak immune system, you may not be able to prevent hairy leukoplakia. But finding it early can help you get proper treatment.

July 02, 2022
  1. Leukoplakia. Genetic and Rare Diseases Information Center. https://rarediseases.info.nih.gov/diseases/6897/leukoplakia. Accessed April 10, 2017.
  2. Goldstein BG, et al. Oral lesions. http://www.uptodate.com/home. Accessed April 10, 2017.
  3. Sullivan JL. Clinical manifestations and treatment of Epstein-Barr virus infection. http://www.uptodate.com/home. Accessed April 10, 2017.
  4. Lodi G, et al. Interventions for treating oral leukoplakia to prevent oral cancer (Review). Cochrane Database of Systemic Reviews. http://ovidsp.tx.ovid.com/sp-3.24.1b/ovidweb.cgi?&S=OEPBFPAAJJDDEBDJNCHKEEOBALIJAA00&Link+Set=S.sh.19%7c4%7csl_50. Accessed April 10, 2017.
  5. Kayalvizhi EB, et al. Oral leukoplakia: A review and its update. Journal of Medicine, Radiology, Pathology and Surgery. 2016;2:18.
  6. Saxena A, et al. Leukoplakia: The verrucous varieties. International Journal of Stomatology and Occlusion Medicine. 2016;8:S10.
  7. Detecting oral cancer: A guide for health care professionals. National Institute of Dental and Craniofacial Research. https://www.nidcr.nih.gov/OralHealth/Topics/OralCancer/DetectingOralCancer.htm#. Accessed April 12, 2017.
  8. Salinas TJ (expert opinion). Mayo Clinic, Rochester, Minn. April 18, 2017.