Last reviewed: November 2017
Last updated: July  2016

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • homogeneous white plaques
  • non-homogeneous appearance
  • other causes for white lesions excluded

Other diagnostic factors

  • male sex
  • age >40 years

Risk factors

  • tobacco use
  • alcohol use
  • betel use
  • chronic candidiasis
  • genetic predisposition
  • immunosuppression
  • dyskeratosis congenita (Zinsser-Cole-Engman Syndrome)
  • Fanconi's anaemia
  • sunlight exposure
  • HPV infection
  • Treponema pallidum infection (syphilis)

Diagnostic investigations

Investigations to consider

  • brush biopsy
  • autoantibodies for ANA, double-stranded DNA, and Smith antigen
  • Treponema pallidum serology
Full details

Emerging tests

  • chemiluminescent spectroscopy
  • molecular and chromosomal markers
Full details

Treatment algorithm

ACUTE

Contributors

Authors VIEW ALL

Consultant

Milton J. Dance Jr. Head and Neck Cancer Center

Greater Baltimore Medical Center

Baltimore

MD

Disclosures

JS has delivered testimony as an expert witness in medicolegal cases, chiefly as a defense expert.

We would like to gratefully acknowledge the late Dr Crispian Scully for his contribution to this monograph.

Disclosures

Not received

Peer reviewers VIEW ALL

Oral Pathologist

Department of Oral Pathology

School of Dentistry

University of Copenhagen

Copenhagen

Denmark

Disclosures

FP declares that he has no competing interests.

Professor and Head

Department of Oral and Maxillofacial Surgery/Oral Pathology

Vrije Universiteit Medical Center

Amsterdam

The Netherlands

Disclosures

IVdW declares that he has no competing interests.

Associate Professor

Head

Division of Oral Medicine

Department of Dental Diagnostic Science

Dental School

University of Texas Health Science Center

San Antonio

TX

Disclosures

MH declares that he has no competing interests.

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