Leukoplakia
DESCRIPTION: We use the term leukoplakia to mean a white lesion of mucous membrane that cannot be identified as any other “white” disease such as candidiasis or lichen planus. It carries no histologic connotation. Using this definition, biopsy is required for accurate diagnosis. Biopsy of oral leukoplakia will most often show hyperkeratosis, a purely reactive and harmless lesion. About 20%, however, will show dysplasia, a premalignant lesion or cancer. Leukoplakia is more common in males and favors older age groups. There are usually no symptoms.
ETIOLOGY: The exact cause is unknown although physical trauma, smoking, excessive alcohol intake and vitamin A deficiency are suspected.
TREATMENT: The treatment depends on the histologic findings and the extent of the lesion. For simple hyperkeratosis, removal of any apparent cause is indicated. Those showing dysplasia, or carcinoma, should be treated with the usual methods used in treatment of cancers.
PROGNOSIS: As stated above, the prognosis depends to a great extent on the precise histologic findings. One study indicates approximately 20% of oral leukoplakia lesions are dysplastic or malignant on the day of biopsy. Leukoplakia in the floor of the mouth and lateral/ventral tongue mucosa are more likely to be precancerous.
DIFFERENTIAL DIAGNOSIS: Lichen planus, candidiasis, and hairy leukoplakia.
