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Erythroplakia is the scientific term for abnormal red patches that can form inside the mouth. Though not usually cancerous themselves, they are frequently precancerous and therefore have a high probability of turning into oral cancer one day.  

What causes erythroplakia? Are there different types, as with leukoplakia? And, does it ever go away on its own? 

Read on for the answers to these and five other questions. 

What causes erythroplakia?

It¡¯s usually caused by smoking, chewing tobacco, heavy alcohol use, and/or local irritation. While erythroplakia can occur without a clear cause, these lesions are most often found in smokers, individuals exposed to toxic irritants, and people with nutritional deficiencies. 

We don¡¯t fully understand the exact mechanism yet, but it¡¯s believed that the damaging effects of tobacco, alcohol and other irritants can lead to changes in the cells lining the mouth, potentially causing abnormal growth that leads to cancer. 

Are there different types of erythroplakia, as with leukoplakia, or just one?

No. Unlike leukoplakia, erythroplakia is generally considered a single entity, though there can be mixed lesions called erythroleukoplakia (speckled leukoplakia) where both red and white patches are present.   

When biopsied, erythroplakial oral lesions tend to be: 

• epithelial dysplasia: cells that just look abnormal under a microscope 
• oral carcinoma in situ: also knowns as ¡°stage zero cancer,¡± this is a precancerous condition in which cancer cells are present in the lining of the mouth, but have not spread; in situ means ¡°in its original place¡± 
• invasive squamous cell carcinoma: a type of oral cancer

What does erythroplakia actually look like?

Erythroplakia usually appears as red, patchy lesions on the mucous membranes of the mouth. It¡¯s often described as having a velvety or granular texture. It could be flat or slightly raised and may bleed when scraped. Common locations include the floor of the mouth, tongue and soft palate. 

What else can be mistaken for erythroplakia?

Several other conditions can mimic erythroplakia, including: 

• oral candidiasis: also known as thrush  
• erosive lichen planus: a chronic inflammatory condition  
• oral mucositis: an inflammation of the mouth lining  
• systemic lupus erythematosus: an autoimmune disease   

There are other inflammatory and infectious conditions that can resemble erythroplakia, too. That¡¯s why a careful assessment is essential to getting an accurate diagnosis.  

Does erythroplakia ever hurt or itch?

Erythroplakia is not typically associated with itching, though some individuals experience discomfort, a burning sensation, or a feeling of soreness. Most people who have erythroplakia report no symptoms. That¡¯s why it¡¯s usually found during a dental exam or when someone brushes their teeth too hard and their mouth starts bleeding.