Oral cavity & oropharynx
Potentially malignant & dysplasia

Topic Completed: 1 November 2013

Minor changes: 9 December 2020

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PubMed Search: Leukoplakia[TI] oral cavity[TIAB]

Nat Pernick, M.D.
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Cite this page: Pernick N. Leukoplakia. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/oralcavityleukoplakia.html. Accessed January 16th, 2021.
Definition / general
  • White patch or plaque, 5 mm or more, on oral mucous membranes that cannot be removed by scraping, not due to another disease entity such as lichen planus or candidiasis and not reversed by removal of irritants
  • Nonspecific clinical term; lesion must be considered precancerous until proven otherwise
  • Ages 40 - 70 years, 65% male, associated with tobacco use, alcohol, ill fitting dentures, chronic exposure of persistent irritants and HPV 16 in tobacco lesions
  • Most common location is buccal gingival gutter; lesions in floor of mouth are often dysplastic
  • Erythroplakia (dysplastic leukoplakia): red, velvety, eroded area, level or depressed; usually associated with highly atypical epithelial changes with thin and atrophic epithelium and prominent vasculature
  • Speckled leukoplakia: leukoplakia and erythroplakia; often has Candida infection also
  • Overall 4% risk for carcinoma; highest if speckled or warty or occurs in floor of mouth or ventral surface of tongue
  • Biopsy if no response to tobacco or alcohol cessation
Gross description
  • Occurs anywhere in oral mucosa; solitary or multiple, variable appearance
Microscopic (histologic) description
  • Varies histologically from acanthosis, hyperkeratosis, dysplasia or carcinoma in situ
  • Carcinoma in situ is associated with lymphocytes and macrophages
  • Erythroplakia is usually at least low grade dysplasia, with intensive inflammation and vascular dilation that causes the red appearance
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