Summary
Definition
History and exam
Key diagnostic factors
- homogeneous white plaques
- other causes for white lesions excluded
- nonhomogeneous appearance
Other diagnostic factors
- male sex
- age >40 years
Risk factors
- tobacco use
- alcohol use
- areca nut (betel quid) use
- chronic candidiasis
- genetic predisposition
- immunosuppression
- Fanconi anemia
- sunlight exposure
- HPV infection
- Treponema pallidum infection (syphilis)
Diagnostic investigations
1st investigations to order
- incisional biopsy
Investigations to consider
- brush biopsy
- autoantibodies for antinuclear antibody (ANA), double-stranded DNA, and Smith antigen
- Treponema pallidum serology
Emerging tests
- chemiluminescent spectroscopy
- molecular and chromosomal markers
- photodynamic diagnosis (PDD) using 5-aminolevulinic acid (ALA-PDD)
- vital staining with toluidine blue
Treatment algorithm
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
Declarações
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
Declarações
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
Declarações
MH declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Lingen MW, Abt E, Agrawal N, et al. Evidence-based clinical practice guideline for the evaluation of potentially malignant disorders in the oral cavity: a report of the American Dental Association. J Am Dent Assoc. 2017 Oct;148(10):712-27;e10.Texto completo Resumo
Lodi G, Franchini R, Warnakulasuriya S, et al. Interventions for treating oral leukoplakia to prevent oral cancer. Cochrane Database Syst Rev. 2016 Jul 29;(7):CD001829.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Oral squamous cell carcinoma
- Chronic candidiasis
- Submucous fibrosis
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