Proper dental care involves regular dental checkups. These checkups not only evaluate the success of your daily dental hygiene; they also assess the overall health of your mouth. One condition your dentist will be on the lookout for is erythroplakia. Erythroplakia is a precancerous condition that is very treatable if caught early.

What is erythroplakia?

First discovered in 1852 in the digestive tract, erythroplakia is characterized by a reddened, velvety textured patch that cannot be explained by other trauma or pathology.

There are three types of erythroplakia, divided by their appearance.

  1. Homogenous: Homogeneous erythroplakia consists of soft, red, raised lesions with clear outlines.
  2. Erythroplakia with patches of leukoplakia: Leukoplakia is a condition of raised white patches. It does not always form in conjunction with leukoplakia, but when it does they are usually located next to each other
  3. Granular or speckled: Lesions are soft, raised, and lightly speckled with white.

These premalignant lesions can appear anywhere in the mouth, including on the tongue and the throat. While most of these lesions appear inside the mouth and throat (including the pharynx and larynx), they can sometimes appear on the vermilion surfaces of the mouth. This is the area where the inside of the mouth changes to the outside of the mouth – most commonly on the lower lip.

Regardless of where they are located, most lesions are usually less than 15 millimeters in diameter. In some cases, lesions can grow to four centimeters or more.

Erythroplakia risk factors

There are several risk factors for developing this condition.

Age and gender

Erythroplakia most frequently effects men in their 60s and 70s. Older patients have a higher risk of developing cancer as a result of these premalignant lesions.


Smokers of all ages and genders are most at risk for this precancerous condition. As more women smoke, the incidence of this condition in women is increasing.

Excessive consumption of alcohol

Excessive consumption of alcohol can contribute to the development of erythroplakia.

Secondary infection or the super infection with candidiasis

Erythroplakia lesions can appear as a result of secondary infection or a super infection with candidiasis (also known as an oral yeast infection). In some cases, these lesions disappear with the use of an antifungal spray and are not precancerous.

What are erythroplakia symptoms?

Symptoms are simple and mostly visual. A red patch (as described above) appears and does not go away. Patients sometimes dismiss erythroplakia early stages as insignificant. They may not even notice a reddened or slightly raised patch in their mouth or throat.

In some cases, erythroplakia early stages symptoms include:

  • Sensitivity to hot or spicy foods
  • Varying degrees of soreness
  • Aching
  • A throbbing sensation

In the case of throbbing pain and sensitivity, this may indicate underlying inflammation that means the lesion is not erythroplakia. Burning or stabbing sensations can indicate neural involvement. Pain may be related to peripheral neuropathy or another nerve disorder that can also cause redness in patches.

Is erythroplakia painful?

Unfortunately, when this condition becomes painful, it often means the premalignant lesions are cancerous.

It is important to pay attention to any changes in your oral health, especially ones that lead to pain.

Diagnosing erythroplakia

Nearly 40% of erythroplakia lesions are cancerous, so early diagnosis is important. To make a diagnosis, your dentist will conduct a thorough examination. They may also use other diagnostic tools, such as X-rays and MRIs.

Biopsy of identified lesions is highly recommended, as the incidence of carcinoma is high in erythroplakia.

Although biopsy of oral lesions is recommended, there are other possible diagnoses, including:

  • Trauma
  • Vasodilation
  • Vascular proliferation (increased blood vessels due to inflammation)
  • Leaking blood vessels
  • Epithelial thinning

If an underlying condition can be identified, chances are good that the condition is not erythroplakia. Diagnosis during erythroplakia early stages can be challenging due to the asymptomatic nature of the condition. Just having a red patch in the mouth, even one that looks like erythroplakia, does not mean it is a precancerous lesion.

Is erythroplakia curable?

Diagnosed early, this condition is highly treatable.

In most cases, your dentist will order a biopsy to determine whether or not the lesions are precancerous. There are two types of biopsies: brush and surgical. A brush biopsy uses a small stiff-bristled brush to remove cells on the outside of the