Description: We use the term leukoplakia to mean a white lesion of mucous membrane. It carries no histologic connotation. Using this definition, biopsy is required for accurate diagnosis.
Biopsy of most oral leukoplakia will show hyperkeratosis, a purely reactive and harmless lesion. Some, however, will show dysplasia, a premalignant lesion. A small number will show carcinoma in-situ or invasive carcinoma. The leukoplakia shown in figure 56 was dysplastic (premalignant).
Leukoplakia is more common in males and favors older age groups. It produces no symptoms.
Etiology: The exact etiology is unknown although physical trauma, smoking, excessive alcohol intake and vitamin A deficiency are suspected.
Treatment: The treatment depends on the histologic findings and the extent of the lesion. For simple hyperkeratosis, removal of any apparent cause is indicated. Those showing dysplasia, or carcinoma, should be treated with the usual methods used in treatment of cancers.
Prognosis: As stated above, the prognosis depends to a great extent on the precise histologic findings. One study indicates approximately 20% of oral leukoplakia lesions will be dysplastic or malignant on the day of biopsy.
Differential diagnosis: Hyperkeratosis, dysplasia, squamous carcinoma, lichen planus, candidosis, and lupus erythematosis