Oral erythroplakia

Erythroplakia is a clinical term for a potentially malignant fiery red lesion that cannot be attributed to any particular condition (see Erythroplakia of the right postero-lateral surface of the tongue). Lesions are usually asymptomatic and isolated, and commonly appear on the floor of the mouth, tongue, soft palate and buccal mucosa. Lesions may appear as smooth, velvety, granular or nodular plaques, often with clear margins. Oral erythroplakia most commonly affects middle-aged and elderly men.

Note: Approximately 70 to 90% of oral erythroplakia lesions are carcinoma in situ or squamous cell carcinoma upon presentation.

Urgent referral to a specialist for biopsy of oral erythroplakia lesions is essential because approximately 70 to 90% are carcinoma in situ or squamous cell carcinoma upon presentation¹ —see Oral cancer. Periodic review and repeated biopsy by the managing specialist is recommended for all patients with oral erythroplakia, because malignant transformation is common.

Figure 1. Erythroplakia of the right postero-lateral surface of the tongue

¹ The treating specialist should perform the biopsy of an oral mucosal lesion. In rural or remote areas where a delay in specialist review is expected, seek expert advice on biopsy technique—a punch biopsy is not appropriate.Return