Erythroplakia appears as abnormal red lesions on the mucous membranes in the oral cavity. The lesions typically occur on your tongue or on the floor of the mouth. The lesions of erythroplakia can’t be scraped off. Erythroplakia lesions are often found along with the leukoplakia lesions. Leukoplakia lesions appear as similar patches but leukoplakia lesions are white in color while erythroplakia are red in color.


  • Erythroplakia has an unknown cause but researchers presume that it might be similar to the causes of squamous cell carcinoma.Carcinoma is found in almost 40% of erythroplakia. It is mostly found in elderly men around the ages of 65 - 74 years. It is commonly associated with smoking.

  • Alcohol and tobacco consumption have been described as risk factors for erythroplakia.

  • Ill-fitting dentures which constantly irritate the gums or other tissues inside oral cavity may also cause leukoplakia or erythroplakia.


  • Although the terms erythroplasia and erythroplakia are used synonymously, some sources distinguish them, stating that the latter is a macular lesion while the former is a papular lesion. Erythroplakia of the genital mucosae is referred to as erythroplasia.

  • The most common areas in the mouth where erythroplakia is found are the floor of the mouth, buccal vestibule, the tongue, and the soft palate, it appears as a red macule or plaque with well-demarcated borders, and the texture is characterized as soft and velvety. An adjacent area of leukoplakia may be found along with the erythroplakia

  • The symptom of erythroplakia may also include bleeding on slight touch.


  • Erythroplakia often develops without pain, discomfort or any other symptoms, it can go unnoticed until it’s found by the dentist or dental hygienist.

  • If your dentist suspects erythroplakia, they’ll closely examine the site of occurrence, often using gauze, instruments, and through palpation. They’ll enquire about the history of the lesion to rule out other causes, like trauma etc.

  • If the lesion bleeds easily even on slight touch, there’s a higher chance of confirming it as erythroplakia, according to the American Cancer Society.

Differential diagnosis

  • Acute atrophic candidiasis
  • Erosive lichen planus
  • Hemangioma
  • Lupus erythematosus
  • Non-homogeneous leukoplakia
  • Pemphigus


After confirmation of erythroplakia, biopsy is sent to rule out cancerous cells.

The biopsy findings, along with the location and size of the lesion, will inform the treatment procedure. Your doctor may recommend the following

  • Observation or review check-ups(frequent follow-ups)
  • Laser surgery
  • Cryosurgery
  • Radiation therapy

Your doctor will also suggest avoiding consumption of tobacco products and reducing or eliminating alcohol use.

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