In this article
- Tobacco and betel nut are major risk factors
- Painless patches still need examination
- Biopsy may be needed to assess risk
Assessment and treatment
- Stop tobacco and betel-nut products
- Full mouth and neck examination
- Biopsy and surveillance when indicated
At a glance
Definition: A persistent white patch that does not rub off may be leukoplakia; some lesions contain precancerous changes.
Key takeaways
- Tobacco and betel nut are major risk factors
- Painless patches still need examination
- Biopsy may be needed to assess risk
Clinical steps
- Stop tobacco and betel-nut products
- Full mouth and neck examination
- Biopsy and surveillance when indicated
Red flags: A red-white patch, ulceration, hardness, bleeding or any lesion lasting over three weeks needs prompt review.
Quick FAQ: When should I see an ENT specialist?
A red-white patch, ulceration, hardness, bleeding or any lesion lasting over three weeks needs prompt review.
How I assess this in clinic
I first clarify duration, severity, whether symptoms are one-sided or bilateral, and their effect on daily life. I then perform a focused ENT examination and compare the findings with tobacco and betel nut are major risk factors.
Endoscopy or audiometry is not required for everyone. I advise endoscopy when the nose, sinus, throat or voice box needs direct assessment, and audiometry/tympanometry when hearing or middle-ear function is in question.
A common misconception is that every ENT problem needs an antibiotic or an operation. Treatment should instead follow the diagnosis, functional impact, examination findings and evidence-based indications.
Do not wait when: A red-white patch, ulceration, hardness, bleeding or any lesion lasting over three weeks needs prompt review.
For patient education; not a substitute for individual diagnosis or treatment.