Oral Erythroplakia

Oral Erythroplakia

Erythroplakia is a clinical term for a potentially malignant fiery red lesion that cannot be attributed to any particular condition.

Signs and Symptoms

Lesions are usually asymptomatic and isolated, and commonly appear on the floor of the mouth, tongue, soft palate and buccal mucosa. Lesions may appear as smooth, velvety, granular or nodular plaques, often with clear margins.

Oral erythroplakia most commonly affects middle-aged and elderly men.

Approximately 70 to 90% of oral erythroplakia lesions are carcinoma in situ or squamous cell carcinoma upon presentation.


Urgent referral to a specialist for biopsy of oral erythroplakia lesions is essential. The reason is, 70 to 90% are carcinoma in situ or squamous cell carcinoma upon presentation 

Periodic review and repeated biopsy by the managing specialist is recommended for all patients with oral erythroplakia, because malignant transformation is common.

Erythroleukoplakia on the right lateral tongue presenting as a mixed red-white patch [1]

The treating specialist should perform the biopsy of an oral mucosal lesion. In rural or remote areas where a delay in specialist review is expected, seek expert advice on biopsy technique. A punch biopsy is not appropriate.


  1. Therapeutic guidelines: Oral and Dental