Last reviewed: March 2020
Last updated: March  2020

Summary

Definition

History and exam

Key diagnostic factors

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

Risk factors

  • tobacco use
  • alcohol use
  • betel use
  • chronic candidiasis
  • genetic predisposition
  • immunosuppression
  • 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
More investigations to consider

Emerging tests

  • chemiluminescent spectroscopy
  • molecular and chromosomal markers
More emerging tests

Treatment algorithm

Contributors

Consultant

Milton J. Dance Jr. Head and Neck Cancer Center

Greater Baltimore Medical Center

Baltimore

MD

Disclosures

JS declares that he has no competing interests.

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

Peer reviewersVIEW 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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