Oral leukoplakia

Last reviewed: 2 Sep 2022
Last updated: 11 Mar 2020

Summary

Definition

History and exam

Key diagnostic factors

  • homogeneous white plaques
  • other causes for white lesions excluded
  • nonhomogeneous appearance
More key diagnostic factors

Other diagnostic factors

  • male sex
  • age >40 years
Other diagnostic factors

Risk factors

  • tobacco use
  • alcohol use
  • betel use
  • chronic candidiasis
  • genetic predisposition
  • immunosuppression
  • Fanconi anemia
  • 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 ANA, double-stranded DNA, and Smith antigen
  • Treponema pallidum serology
More investigations to consider

Emerging tests

  • chemiluminescent spectroscopy
  • molecular and chromosomal markers

Treatment algorithm

ACUTE

all patients

Contributors

Authors

James Sciubba, DMD, PhD

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.

Acknowledgements

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

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