 Hello everyone welcome back to another session in dentistry and more. Today we have pre-cancerous lesions and conditions. So this session is about erythroplegia and Casinoma in situ. They are pre-malignant lesions. So pre-malignant lesions they are nothing but morphologically altered tissue in which cancer is more likely to occur than it is apparently normal counterpart. So another thing is pre-cancerous condition. It is a generalized state of the body which is associated with significantly increased risk of cancer. So pre-cancerous or pre-malignant lesions are leukoplecia, erythroplecia, Casinoma in situ, dyscoratosis, follicularis, Bowans disease whereas pre-malignant conditions are the most common OSMF or Lycan planus, syphilitic, glossitis, sytropenic dysphagia, dyscoratosis, congenital. So this is about pre-malignant or pre-cancerous lesions. They are leukoplecia, erythroplecia, Casinoma in situ. So today's session is about erythroplecia and Casinoma in situ. Locoplecia we have already covered in this channel. So you can watch the video which was uploaded previously. Similarly pre-malignant conditions like oral submucous fibrosis or Lycan planus. So all those things are already been uploaded. Now let's learn about erythroplecia and Casinoma in situ. Erythroplecia by definition is any lesion of the oral mucosa that presents as a bright red velvety patch or plaque which cannot be characterized clinically or pathologically as any other recognizable condition. And the classification as homogenous erythroplecia, erythroplecia interspersed with patches of leukoplecia and granular or speckled erythroplecia. Homogenous one with interspersed with leukoplecia and granular or speckled erythroplecia. So the most common etiology is just as leukoplecia and it is mainly affecting the middle age people and the peak insurgency 65 to 74 years. Gender prediction is on men and the location and size. So location basically it's seen on soft palate, floor of the mouth, buccal mucosa and tongue. Whereas the size the typical lesion most commonly less than 1.5 cm but sometimes it may reach up to greater than 4 cm. So it appears as smooth and granular or nodular lesion which is well defined may be an irregular or red granular surface which is interspersed with white or yellow foci. And it will be soft on palpation and which has highest risk of malignant transformation that is around 14 to 50 percentage of malignant transformation for erythroplecia. And based on the fact that on histology these 80 to 90 percentage of the cases present as carcinoma in situ, severe epithelial dysplasia and microinvasive carcinoma, microinvasive carcinoma. So most of the cases will be histologically as carcinoma to severe epithelial dysplasia or microinvasive carcinoma. So on management side we have to first think of biopsy then treatment guided by the histopathological diagnosis. Recurrence is a common thing so we need to have a careful long follow up because since the recurrence is high we need to have a careful longer follow up. So that is all about erythroplecia which is having highest malignant transformation it's almost like leukoplecia but little different in classification. Now let's move on to carcinoma in situ. Carcinoma in situ is intraepithelial carcinoma, intraepithelial carcinoma. It's a very peculiar type right because carcinoma we have metastasis which is spreading to various tissues but this is intraepithelial carcinoma which is confined within the boundaries which arises frequently on the skin but also on mucus membranes including oral cavity which is most severe stage of epithelial dysplasia. The most striking feature is the dysplastic epithelial cells do not invade into the connective tissue that is the most striking feature do not invade to connective tissue. So the common among elderly with a male predilection which present as a white plague or ulcerated or reddened areas the most common site is floor of the mouth floor of the mouth, tongue and lips these are the most common sites and has a combined features of leukoplecia and erythroplecia, okay leukoplecia and erythroplecia these features are combined. In histopathology there will be keratin may or may not be present but if present it is usually para keratin and individual cell keratinization or keratin pearl formations are rare the consistent finding there will be loss of orientation and normal polarity of cells. So orientation and normal polarity will be lost and regarding the treatment there is no accepted treatment you could go for surgical excision radiation therapy or characterization so that is about carcinoma in situ and erythroplecia. So these are pre malignant lesions leukoplecia carcinoma in situ erythroplecia. So the questions usually come as explain about or classify pre malignant lesions and pre malignant conditions and explain about oral lichen planus osm of erythroplecia or leukoplecia okay you need to write the classification first then the most commonly asked is either leukoplecia or oral lichen planus or osm of these are most commonly asked question erythroplecia carcinoma in situ could be a shock not. So the basic difference is one is lesion and one is condition so the oral lichen planus osm of our condition whereas the leukoplecia erythroplecia are the lesions okay. So that's all about pre malignant lesions and conditions particularly erythroplecia and carcinoma in situ so I'll come up with a new topic in the industry and more thank you.