Definition Leukoplakia is a clinical term, and the lesion is defined as awhite patch or plaque, firmly attached to the oral mucosa, that cannot be classified as any other disease entity. It is a precancerous lesion.
Etiology The exact etiology remains unknown. Tobacco, alcohol, chronic local friction, and Candida albicans are important predisposing factors. Human papilloma virus (HPV) may also be involved in the pathogenesis of oral leukoplakia.
Clinical features Three clinical varieties (Figs. 1 and 2) are recognized: homogeneous (common), speckled (less common), and verrucous (rare). Speckled and verrucous leukoplakia have a greater risk for malignant transformation than the homogeneous form. The average percentage of malignant transformation for leukoplakia varies between 4% and 6%. The buccal mucosa, tongue, floor of the mouth, gingiva, and lower lip are the most commonly affected sites.
Laboratory tests Histopathological examination.
Differential diagnosis Lichen planus, cinnamon contact stomatitis, candidiasis, hairy leukoplakia, lichen planus reactions, chronic biting, tobacco pouch keratosis, leukoedema, chemical burn, uremic stomatitis,skin graft, some genodermatoses and discoid lupus erythematosus.
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Treatment Elimination or discontinuation of predisposing factors, systemic retinoid compounds. Surgical excision is the treatment of choice.
Fig. 1 Homogeneous leukoplakia.
Fig. 2 Speckled leukoplakia.
