Эритроплакия: Клиника, диагностика и лечение предракового состояния

Erythroplakia is a clinical term to describe any erythematous (red) area on a mucous membrane, that cannot be attributed to any other pathology. The term erythroplasia was coined by Louis Queyrat to describe a precancerous red lesion of the penis. This gave rise to the term erythoplasia of Queyrat. Depending upon the context, this term may refer specifically to carcinoma in situ of the glans penis or vulva appearing as a red patch, or may be used as a synonym of erythroplasia on other mucous membrane or transitional sites. It mainly affects the glans penis (the head of the penis), although uncommonly it may present on the mucous membranes of the larynx,

Erythroplakia is analogous to the term leukoplakia which describes white patches. Together, these are the 2 traditionally accepted types of premalignant lesion in the mouth, When a lesion contains both red and white areas, the term "speckled leukoplakia" or "eyrthroleukoplakia" is used. Although oral erythroplakia is much less common than leukoplakia, erythroplakia carries a significantly higher risk of containing dysplasia or carcinoma in situ, and of eventually transforming into invasive squamous cell carcinoma (a type of oral cancer). Erythroplakia of the genital mucosae is often referred to as erythroplasia of Queyrat. The most common areas in the mouth where erythroplakia is found are the floor of the mouth, buccal vestibule, the tongue, and the soft palate. It appears as a red macule or plaque with well demarcated borders. The texture is characterized as soft and velvety. An adjacent area of leukoplakia may be found along with the erythroplakia. Erythroplasia may also occur on the laryngeal mucosa, It is mostly found in elderly men around the ages of 65 74. It is commonly associated with smoking. Alcohol and tobacco use have been described as risk factors.

There are many other conditions that are similar in appearance and must be ruled out before a diagnosis of erythroplakia is made (see table). Sometimes, a diagnosis is delayed for up to two weeks in order to see if the lesion spontaneously regresses on its own or if another cause can be found. Erythroplakia frequently is associated with dysplasia, and is thus a precancerous lesion.

Microscopically, the tissue exhibits severe epithelial dysplasia, carcinoma in situ, or invasive squamous cell carcinoma in 90% of cases. There is an absence of keratin production and a reduced number of epithelial cells. Since the underlying vascular structures are less hidden by tissue, erythroplakia appears red when viewed in a clinical setting.

Treatment involves biopsy of the lesion to identify extent of dysplasia. Complete excision of the lesion is sometimes advised depending on the histopathology found in the biopsy. Even in these cases, recurrence of the erythroplakia is common and, thus, long term monitoring is needed.

In 1911, French dermatologist Louis Queyrat described a sharply defined, bright red, glistening velvety precancerous lesion of the glans penis. the term became erythroplakia in English. It is unclear when the term erythroplakia was first adapted to describe red lesions in the mouth.