Internal Medicine

0521779407-13 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:15

904 Leukopenia Leukoplakia

■Drug induced neutropenia: stop drug, may speed recovery with G-

CSF

follow-up

■Follow-up dependent on underlying diagnosis

complications and prognosis

■Major risk of severe neutropenia is overwhelming infection

■Prognosis dependent on the recovery of neutrophils, underlying

diagnosis

LEUKOPLAKIA

SOL SILVERMAN JR, DDS

history & physical

■white patch on any mucosal surface that cannot be wiped off

■usually soft and asymptomatic

■can be flat or verrucal

■pain and/or red component increases risk for dysplasia, carcinoma

■adult onset; duration variable (months to years)

■often associated with smoking; can be idiopathic

tests

■biopsy

differential diagnosis

■epithelial dysplasia, carcinoma, candidiasis, lichen planus

management

■remove irritants, e.g. tobacco, spicey/hot foods, other irritants

specific therapy

■surgical excision; laser very effective

■chemoprevention not effective and can be toxic

follow-up

■watch for changes in signs, symptoms, pain, extension

■observe for recurrence if excised

complications and prognosis

■moderate risk for spread and/or transformation to carcinoma