white 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 Several 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.
Treatment Elimination or discontinuation of predisposing factors, systemic
retinoid compounds. Surgical excision is the treatment of choice.
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