Leukoplakia

Swimmer, 1877.

Oral leukoplakia.

Nonwipeable, white, irritation-unspecific mucosal patch in which there is increased or abnormal keratinisation.

• Age peak: 40-70 y.
• Men > Women

• Exogenous-irritative
  • Chronic, physical stimuli
• Mechanical
  • Dental prostheses
• Chemical
  • Nicotine abuse
• Viruses
  • Human papillomaviruses, especially types 1, 6 & 16

Mostly solitary, but in some cases also multiple whitish to greyish areas with smooth to verrucous surface.

• Clinical findings
• Biopsy

• Transition to
  • spinocellular carcinoma
  • florid oral papillomatosis

Chronic progression.

• Alcohol and nicotine abstinence
• Avoidance of all possible triggers
• Excision
• Cryosurgery
• After bioptic backup: curettage / laser / ablation with CO2

1. Silverman S, Gorsky M. Proliferative verrucous leukoplakia. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 1997;84:154-7. 
2.  Aquilina C, Viraben R, Denis P. Secondary syphilis simulating oral hairy leukoplakia. Journal of the American Academy of Dermatology 2003;49:749-51. 
3.  van der Hem PS, Nauta JM, der Wal JEv, Roodenburg JLN. The results of CO2 laser surgery in patients with oral leukoplakia: a 25 year follow up. Oral Oncology 2005;41:31-7. 
4.  Bagan JV, Jimenez Y, Murillo J, et al. Lack of Association Between Proliferative Verrucous Leukoplakia and Human Papillomavirus Infection. Journal of Oral and Maxillofacial Surgery 2007;65:46-9. 
5.  Cabay RJ, Morton TH, Epstein JB. Proliferative verrucous leukoplakia and its progression to oral carcinoma: a review of the literature. Journal of Oral Pathology & Medicine 2007;36:255-61. 
6.  van der Waal I, Reichart PA. Oral proliferative verrucous leukoplakia revisited. Oral Oncology 2008;44:719-21.