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August 1981

Leukoedema, Reactive Hyperkeratosis, or Cheek Biting-Reply

Author Affiliations

Rochester, Minn

San Antonio, Tex

Arch Dermatol. 1981;117(8):454-455. doi:10.1001/archderm.1981.01650080006011

In Reply.—  We appreciate Krutchkoff's interest in our article and the fact that he took the time to express his opinions. However, he apparently did not understand the whole spectrum of leukoedema and has not read the article by Sandstead and Lowe1 (reference 1 in our article). They coined the term "leukoedema." The clinical appearance of leukoedema mentioned by Krutchkoff is the mild, but most frequent, form of the disorder. (We did mention that in the article.) Nevertheless, there are different degrees of leukoedema. Sandstead and Lowe assessed these as: "Slight— mucosa was opalescent, thickened, and with the capillary network obliterated; the entire mucosa may be involved but the middle and posterior cheek was principally affected; the edematous appearance disappeared upon stretching. Moderate—mucosa possessed a coarsely granular surface with a definite white or whitish-gray appearance that persisted upon stretching. Severe—mucosa appeared grayish white and thickened; in some cases it

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