. Syphilis : a treatise on etiology, pathology, diagnosis, prognosis, prophylaxis, and treatment . s of syphilitic origin. At the present time most observ-ers believe that the majority of cases of leucoplakia are directlydue to syphilis, but that a certain percentage of cases are smoking is undoubtedly a factor in the developmentof this disease. Another factor that should never be disregardedis irritation produced by rough teeth. McDonagh^ goes so faras to say that leucoplakia is simply the effort on the part of the 174 SYPHILIS tongue to produce a covering that will resist irrit
. Syphilis : a treatise on etiology, pathology, diagnosis, prognosis, prophylaxis, and treatment . s of syphilitic origin. At the present time most observ-ers believe that the majority of cases of leucoplakia are directlydue to syphilis, but that a certain percentage of cases are smoking is undoubtedly a factor in the developmentof this disease. Another factor that should never be disregardedis irritation produced by rough teeth. McDonagh^ goes so faras to say that leucoplakia is simply the effort on the part of the 174 SYPHILIS tongue to produce a covering that will resist irritation, andthat it can usually be cured by removing the irritating , I have seen a number of instances where this did notsuffice to remove the lesions characteristic of the disorder. The parts usually attacked are the dorsal and lateral surfacesof the tongue and the buccal mucosa at the tooth line. Whenwell-developed, white, thickened plaques that soon become con-fluent can be seen. Later there is some Assuring. The tongueis verv sensitive to tobacco smoke or to hot or cold food or. Fig. 96.—While irritants play an important part in causing leucoplakia, still syphilisis frequently a most important predisposing factor. (Collection of Drs. Fordyce andMacKee.) drinks. A large percentage of these lesions eventually becomecarcinomatous. Histologically there is both parakeratosis andacanthosis, with an atrophy of the papillae. There is round-celledinfiltration in the submucous tissue. If the disease is seen early all irritating substances should be pro-hibited; this means that smoking must be forbidden, and that nohighly spiced foods are to be eaten. Neither should very hot norvery cold substances be taken. The teeth should be carefully goneover. If after three months of such a regime there is not re- AFFECTIONS OF THE MOUTH AND THROAT 175 covery, the patches should be removed with the cautery. Underno circumstances should superficial caustics be applied; theyare simply
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