Leukoedema (白色水肿)


Milky white appearance affecting almost the entire buccal mucosa.


Same patient as seen in Fig. 1.10, showing disappearance of the white change when the cheek is stretched.

Leukoedema is a bilateral, white, opalescent appearance of the buccal mucosa that may represent a normal variation in anatomy. The white appearance is created by an increase in thickness of the surface epithelium, which includes numerous cells with prominent intracellular edema. Leukoedema exhibits a predilection for blacks, among whom it has been described in 70% to 90% of adults and 50% of children. In whites, the condition often has a milder presentation and may be hardly noticeable. Leukoedema in blacks may appear more obvious because of the contrast between the edematous mucosa and background pigmentation. Although leukoedema is considered to be a developmental lesion, the white color can be more prominent in smokers and may become less severe after smoking cessation.

Leukoedema appears as a diffuse, milky, gray-white change in the color of the buccal mucosa, which should be bilateral and symmetric. Often, the mucosal surface appears somewhat folded, resulting in white streaks or wrinkles. The diagnosis can be confirmed easily by stretching and everting the cheek, which will result in disappearance of the opalescent white change. No treatment or biopsy is necessary.

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