II. Definitions
- Oral Leukoplakia
- Well demarcated, white Plaque-like lesion on Oral Mucosa
III. Epidemiology
- Prevalence: 1 to 4% in U.S.
- More common in ages 40 to 70 years old
IV. Risk Factors
- Tobacco Smoking (RR 6)
- Alcohol use
V. Causes
-
General
- Leukoplakia is pre-cancerous (dysplasia or carcinoma in situ) or carcinoma in 10 to 46% of cases
- Speckled Leukoplakia (Erythroleukoplakia) is more likely to be cancer
- Specific Causes
- Leukoedema
- Galvanic keratosis
- Lichen Planus of Buccal Mucosa
- Verrucous carcinoma
- Systemic Lupus Erythematosus
- White sponge nevus
- Squamous Cell Carcinoma
VI. Signs: Cancer-prone mucosal locations
- Lateral or Ventral Tongue
- Floor of mouth (especially near Wharton's Duct)
- Mandibular retromolar trigone
- Tonsillar Pillar and Soft Palate complex
VII. Differential Diagnosis: White Oral Lesions
- See Erythroplakia (red patches)
- Non-Keratotic
- Keratotic (cannot be rubbed off)
- Leukoplakia (18% of Oral Lesions)
- Hyperplastic Candidiasis (at lateral Tongue)
- Reactive hyperkeratosis (most common)
- Benign epithelial response
- Fractured tooth
- Dental restoration
- Benign epithelial response
VIII. Evaluation
- Rule out Traumatic cause
- Biopsy any Leukoplakia lesion that persists >2 weeks!
- Risk of dysplasia, carcinoma in situ or Oral Squamous Cell Carcinoma
- Reevaluate non-dysplastic Leukoplakia lesions every 6 months
- Malignant transformation may occur
IX. Prevention
- Tobacco Cessation
- Alcohol cessation