II. Definitions

  1. Oral Leukoplakia
    1. Well demarcated, white Plaque-like lesion on Oral Mucosa

III. Epidemiology

  1. Prevalence: 1 to 4% in U.S.
  2. More common in ages 40 to 70 years old

IV. Risk Factors

V. Causes

  1. General
    1. Leukoplakia is pre-cancerous (dysplasia or carcinoma in situ) or carcinoma in 10 to 46% of cases
    2. Speckled Leukoplakia (Erythroleukoplakia) is more likely to be cancer
  2. Specific Causes
    1. Leukoedema
    2. Galvanic keratosis
    3. Lichen Planus of Buccal Mucosa
    4. Verrucous carcinoma
    5. Systemic Lupus Erythematosus
    6. White sponge nevus
    7. Squamous Cell Carcinoma

VI. Signs: Cancer-prone mucosal locations

  1. Lateral or Ventral Tongue
  2. Floor of mouth (especially near Wharton's Duct)
  3. Mandibular retromolar trigone
    1. Tonsillar Pillar and Soft Palate complex

VII. Differential Diagnosis: White Oral Lesions

  1. See Erythroplakia (red patches)
  2. Non-Keratotic
    1. Can scrape off with Tongue blade or gauze
    2. Causes
      1. Surface debris (food accretion)
      2. Necrosis
      3. Thrush
  3. Keratotic (cannot be rubbed off)
    1. Leukoplakia (18% of Oral Lesions)
    2. Hyperplastic Candidiasis (at lateral Tongue)
    3. Reactive hyperkeratosis (most common)
      1. Benign epithelial response
        1. Fractured tooth
        2. Dental restoration

VIII. Evaluation

  1. Rule out Traumatic cause
  2. Biopsy any Leukoplakia lesion that persists >2 weeks!
    1. Risk of dysplasia, carcinoma in situ or Oral Squamous Cell Carcinoma
  3. Reevaluate non-dysplastic Leukoplakia lesions every 6 months
    1. Malignant transformation may occur

IX. Prevention

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Related Studies

Ontology: Leukoplakia (C0023531)

Definition (NCI) A white patch or plaque on a mucous membrane that cannot be characterized clinically or pathologically as any other disease. The diagnosis of leukoplakia is one of exclusion; other conditions such as candidiasis, lichen planus, leukoedema, etc., must be ruled out before a diagnosis of leukoplakia can be made. Leukoplakia may be a premalignant condition.
Definition (NCI_NCI-GLOSS) An abnormal patch of white tissue that forms on mucous membranes in the mouth and other areas of the body. It may become cancer. Tobacco (smoking and chewing) and alcohol may increase the risk of leukoplakia in the mouth.
Definition (MSH) A white patch lesion found on a MUCOUS MEMBRANE that cannot be scraped off. Leukoplakia is generally considered a precancerous condition, however its appearance may also result from a variety of HEREDITARY DISEASES.
Concepts Neoplastic Process (T191)
MSH D007971
SnomedCT 156399004, 274134003, 50978000
English Leukoplakias, Lesion, Leukoplakic, Lesions, Leukoplakic, Leukoplakic Lesions, Leukoplakic Lesion, Leukoplakia, Leukoplakia NOS, Leukoplakia [Disease/Finding], leucoplakia, leukoplakia, leukoplakias, leukokeratosis, Leucoplakia, Leukoplakia (disorder), Leukoplakia (morphologic abnormality), Leukoplakia, NOS, Keratotic Plaque
Dutch leukoplakie NAO, leukoplakie, Leukoplakie
French Leucoplasie SAI, Lésions leucoplasiques, Leucoplasie
German Leukoplakie NNB, Leukoplakie
Italian Leucoplachia NAS, Lesioni leucoplasiche, Leucoplachia
Portuguese Leucoplasia NE, Leucoplasia
Spanish Leucoplasia NEOM, Leucoplasia, Leucoplaquia, leucoplaquia (anomalía morfológica), leucoplaquia, leucoplasia (trastorno), leucoplasia, SAI, leucoplasia
Japanese 白斑症NOS, ハクハンショウ, ハクハンショウNOS, 白斑症, 白板症, ロイコプラキー, 白板症(ハクハンショウ)
Swedish Leukoplaki
Czech leukoplakie, Leukoplakie, Leukoplakie NOS
Finnish Leukoplakia
Russian LEIKOPLAKIIA, ЛЕЙКОПЛАКИЯ
Croatian LEUKOPLAKIJA
Polish Rogowacenie białe, Leukoplakia, Leukokeratoza
Hungarian Leukoplakia, Leukoplakia k.m.n.
Norwegian Levkoplaki, Leukoplakisk forandring, Leukoplaki

Ontology: Leukoplakia, Oral (C0023532)

Definition (NCI) A white patch or plaque on the oral cavity mucosa that cannot be characterized clinically or pathologically as any other disease. The diagnosis of leukoplakia is one of exclusion; other conditions such as candidiasis, lichen planus, leukoedema, etc., must be ruled out before a diagnosis of leukoplakia can be made. Leukoplakia may be a premalignant condition.
Definition (NCI) A white patch or plaque on the oral mucosa that cannot be characterized clinically or pathologically as any other disease. The diagnosis of leukoplakia is one of exclusion; other conditions such as candidiasis, lichen planus, leukoedema, etc., must be ruled out before a diagnosis of leukoplakia can be made. Leukoplakia may be a premalignant condition.
Definition (MSH) A white patch seen on the oral mucosa. It is considered a premalignant condition and is often tobacco-induced. When evidence of Epstein-Barr virus is present, the condition is called hairy leukoplakia (LEUKOPLAKIA, HAIRY).
Definition (CSP) white patch seen on the oral mucosa; considered a premalignant condition and is often tobacco-induced.
Concepts Neoplastic Process (T191)
MSH D007972
ICD10 K13.21
SnomedCT 196564008, 62953009, 155663006, 196570002, 414603003
English Leukoplakias, Oral, Oral Leukoplakias, LEUKOPLAKIA ORAL, Oral mucosa leukoplakia NOS, Oral leukoplakia, oral leukoplakia (diagnosis), oral leukoplakia, Leukoplakia of mouth, Leukoplakia oral NOS, Oral leukoplakia NOS, Leukokeratosis of oral mucosa, Leukoplakia, Oral [Disease/Finding], oral keratosis, Leukoplakia;oral, leukoplakia mouth, leukoplakia oral, Leukoplakia, Oral, Leukoplakia buccalis, Oral mucosa leucoplakia NOS, Oral mucosa leukoplakia NOS (disorder), Leukoplakia oral, mouth; leukoplakia, Oral Leukoplakia, Oral Keratoses, Oral Keratosis, Leukokeratosis of Oral Mucosa, Leukoplakia of Mouth, Leukoplakia of Oral Mucosa, Leukoplakia of the Mouth, Leukoplakia of the Oral Mucosa, Mouth Leukoplakia, Oral Cavity Leukoplakia, Leucoplakia of oral mucosa, Leukoplakia of oral mucosa, Leukoplakia of oral mucosa (disorder), Leukoplakia of oral mucosa, NOS, Leucoplakia of oral mucosa, NOS, leukoplakia, oral
Portuguese LEUCOPLASIA BUCAL, Leucoplasia da boca, Leucoplasia oral NE, Língua do Fumante, Placa do Fumante, Leucoplasia Tabagística, Psoríase Bucal, Psoríase da Língua, Leucoceratose, Leucoplasia bucal, Leucoplasia Bucal
Dutch orale leukoplakie NAO, leukoplakie van mond, leukoplakia buccalis, leukoplakie oraal NAO, mond; leukoplakie, leukoplakie oraal, Keratosis, orale, Leukoplakie, orale, Orale leukoplakie
French Leucoplasie buccale SAI, Leukoplasie buccale SAI, Leucoplasie de la bouche, LEUKOPLASIE BUCCALE, Leucoplasie buccale, Leucoplasie de la cavité buccale, Leucoplasie orale
German Leukoplakie des Mundes, Leukoplakie oral NNB, Leukoplakia buccalis, orale Leukoplakie NNB, orale Leukoplakie, Leukoplakia oris, LEUKOPLAKIE MUND, Leukoplakie, orale
Italian Leucoplachia orale NAS, Leucoplachia della bocca, Leucoplachia orale
Spanish Leucoplasia de boca, Leucoplasia oral NEOM, Leucoplasia bucal, Leucoplasia Bucal, LEUCOPLASIA ORAL, leucoplasia de la mucosa bucal, SAI, leucoplasia de la mucosa bucal, SAI (trastorno), gingivoestomatosis plegada blanca, leucoqueratosis de la mucosa oral, Leucoplaquia Bucal, Leucoplasia oral, leucoplasia de la mucosa oral (trastorno), leucoplasia de la mucosa oral, leucoplasia de la mucosa bucal
Japanese 口腔内白斑症NOS, 頬部白斑症, 口腔内白斑症, コウクウナイハクハンショウNOS, キョウブハクハンショウ, コウクウナイハクハンショウ, 口腔白斑, 白板症-口腔, 口腔白板症, 口腔白斑症, 白斑-口腔, 白斑症-口腔
Swedish Leukoplaki, oral
Finnish Suun leukoplakia
Russian LEIKOPLAKIIA ROTOVOI POLOSTI, KERATOZ ROTOVOI POLOSTI, ROTOVOI POLOSTI LEIKOPLAKIIA, КЕРАТОЗ РОТОВОЙ ПОЛОСТИ, ЛЕЙКОПЛАКИЯ РОТОВОЙ ПОЛОСТИ, РОТОВОЙ ПОЛОСТИ ЛЕЙКОПЛАКИЯ
Czech Orální leukoplakie, Bukální leukoplakie, Orální leukoplakie NOS, Leukoplakie úst, leukoplakie orální, orální leukoplakie
Polish Leukokeratoza jamy ustnej, Rogowacenie białe jamy ustnej, Leukoplakia jamy ustnej
Hungarian Oralis leukoplakia, Száj leukoplakiája, Száj leukoplakia k.m.n., Oralis leukoplakia k.m.n., Buccalis leukoplakia
Norwegian Leukoplaki i munn, Oral leukoplaki, Leukoplaki, oral, Levkoplaki i munn, Oral levkoplaki