Oral leukoplakia

Last reviewed: 6 Jan 2023
Last updated: 25 Jan 2023

Summary

Definition

History and exam

Key diagnostic factors

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

Other diagnostic factors

  • male sex
  • age >40 years
Other diagnostic factors

Risk factors

  • tobacco use
  • alcohol use
  • areca nut (betel quid) use
  • chronic candidiasis
  • genetic predisposition
  • immunosuppression
  • Fanconi's anaemia
  • sunlight exposure
  • HPV infection
  • Treponema pallidum infection (syphilis)
More risk factors

Diagnostic investigations

1st investigations to order

  • incisional biopsy
More 1st investigations to order

Investigations to consider

  • brush biopsy
  • autoantibodies for anti-nuclear antibody (ANA), double-stranded DNA, and Smith antigen
  • Treponema pallidum serology
More investigations to consider

Emerging tests

  • chemiluminescent spectroscopy
  • molecular and chromosomal markers
  • photodynamic diagnosis (PDD) using 5-aminolevulinic acid (ALA-PDD)
  • vital staining with toluidine blue

Treatment algorithm

ACUTE

all patients

Contributors

Authors

Saman Warnakulasuriya, DSc, BDS, PhD

Emeritus Professor

Dental Institute at Guy's, King's and St Thomas' Hospitals

Department of Oral Medicine

King's College London

London

UK

Disclosures

SW is an author of several references cited in this topic.

Acknowledgements

Professor Saman Warnakulasuriya would like to gratefully acknowledge Dr James Sciubba and the late Professor Crispian Scully for their contributions to this topic.

Disclosures

JS is an author of some references cited in this topic.

Peer reviewers

Finn Praetorius, DDS

Oral Pathologist

Department of Oral Pathology

School of Dentistry

University of Copenhagen

Copenhagen

Denmark

Disclosures

FP declares that he has no competing interests.

Isaac Van der Waal, DDS, PhD

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.

Michaell Huber, DDS

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.

Use of this content is subject to our disclaimer