Early proliferative verrucous leukoplakia, laser therapy, low level laser therapy. Surgical treatment includes conventional surgery, electrocoagulation, cryosurgery, and laser surgery excision or evaporation. Pdf oral leukoplakia is the most common potentially malignant disorder affecting oral cavity. Leukoplakia, along with other terms, such as vulvar dystrophy, kraurosis vulvae, hyperplastic vulvitis and lichen sclerosus et atrophicus should no longer be used. Photodynamic therapy pdt has demonstrated promising results. In majority of the cases, leukoplakia goes away on its own and does not require any treatment, but it is important to identify the cause of leukoplakia and staying away from it. Read and know what is leukoplakia as well as all about its. For example, if leukoplakia is caused by a rough tooth or an irregular surface on a denture or a filling, the tooth will be smoothed and dental appliances repaired. Leukoplakia is a discomforting condition that affects around 3% of the world population.
For the majority of individuals, quitting alcohol and tobacco use will generally clear the condition. It is appropriate to wait two weeks after the first presentation to assess clinical response to initial treatment, e. Leukoplakiaa diagnostic and management algorithm sciencedirect. Sep 11, 2017 lee akst, director laryngology, john hopkins voice center, discusses leukoplakia treatment. Erythroplakia and speckled leukoplakia are oral precancerous lesions that have a. Histopathology of leukoplakia can disclose hyperkeratosis with dysplasia or carcinoma or hyperkeratosis or parakeratosis without dysplasia.
It often affects people with a weakened immune system, particularly those with hiv and aids or who have had an organ transplant and are taking immunosuppressant medication. May 21, 2012 leukoplakia usually does not cause complications or permanent damage. For language access assistance, contact the ncats public information officer. Oral leukoplakia ol is a white patch or plaque that cannot be rubbed off, cannot be characterized clinically or histologically as any other condition, and is not associated with any physical or chemical causative agent except tobacco. Always seek professional medical advice about any treatment or change in treatment plans. Leukoplakia is one of potentially malignant disorders that can be found on oral mucosa.
Soames and southam reported mutations of p53 in the cells from dysplastic areas of some leukoplakias who smoke and drink heavily. Although the sores can vary in appearance, they are usually white or gray. Oral leukoplakia amsterdam umc vrije universiteit amsterdam. Treatment depends on demographic, social, clinical, and histopathologic factors. Leukoplakia first appears as a small, smooth, white spot that cannot be scraped off but develops into a. Leukoplakia genetic and rare diseases information center. Pdf leukoplakia is the most common premalignant or potentially malignant lesion of the oral mucosa. Hairy leukoplakia is a type of leukoplakia caused by the epsteinbarr virus. Longterm treatment outcome of oral premalignant lesions. Flat leukokeratosis under unfavorable conditions becomes verrucous and further neglect of. This function is accomplished through a ligation between betacarotene and oxygen, which is an unstable reactive molecule, thus diminishing the damaging effects of free radicals lycopene in vitro experiments have shown the inhibition of the process of human neoplastic cellular growth by lycopene, since this. Stoltze a a department of periodontology and department of oral pathology and medicine, school of dentistry, faculty of health sciences, university of copenhagen, 20 norre alle. Leukoplakia can be seen in proximity to malignant lesions and is a response to recurrent inflammation or irritation. Oral leukoplakia is a white patch or plaque that develops in the oral cavity and is strongly associated with smoking.
Oral leukoplakia is a potentially malignant disorder affecting the oral mucosa. May 10, 2019 leukoplakia is a condition in which thick, white or grayish patches form usually inside your mouth. The clinical appearance of the lesion does not necessarily correlate with the histopathologic change changes apparent when examined under a microscope. Jul 16, 2014 the search was conducted in both english and portuguese, and the keywords used were oral hairy leukoplakia, oral hairy leukoplakia and topical management and oral hairy leukoplakia and topical treatment. Treatment for leukoplakia, if needed, involves removing the source of irritation. But other irritants can cause this condition as well. Ol is premalignant and is associated with squamous cell carcinoma scc. Leukoplakia definitionpage contents1 leukoplakia definition2 leukoplakia types3 what is homogeneous leukoplakia. Treatment of oral cancer may consist of surgery, radiotherapy, chemotherapy or. Leukoplakia, precancerous tumour of the mucous membranes, usually seen in the mouth or on the tongue or cheeks, but also known to occur on the lips, as well as on the vagina, vulva, or anus. Although most leukoplakia patches are benign noncancerous, a small percentage show early signs of cancer, and many cancers of the mouth occur next to areas of leukoplakia. The clinical appearances of the lesions were white homogeneous leukoplakia in 48, red and white erythroleukopla kia in 8, and verrucous in 14. If leukoplakia is caused by smoking, you will be asked to minimize or stop smoking or using other tobacco products.
Treat dental causes such as rough teeth, irregular denture surface, or fillings as soon as possible. Leukoplakia is a condition in which thickened, white patches form on the tongue, gums, inside of the cheek, or sometimes on the outer female genitals. These patches are typically painless and usually noncancerous benign. Case report an unusual case report of an early proliferative. Table 2 site distribution of 41 patients with leukoplakia. Sores often clear up a few weeks or months after the source of irritation is removed. The main purpose of oral leukoplakia management is to avoid malignant transformation of the lesion or if this happened to detect this in early stages. Leukoplakiaa diagnostic and management algorithm journal of. Feb 25, 2020 if you have hairy leukoplakia, youll likely be evaluated for conditions that may contribute to a weakened immune system. It often affects people with a weakened immune system, particularly those with hiv and aids or who have had an organ transplant and are taking immunosuppressant medication it causes fuzzy white patches, often on the sides of the tongue, that look folded or ridged. Treatment, if needed, involves removing the source of irritation. Proliferative verrucous leukoplakia is a rare form of ol which has multiple recurrences, is refractory to treatment and has malignant transformation in a short period.
Additional studies were found in the reference lists of the selected articles. If leukoplakia has been caused by tobacco use then abstaining from tobacco use is the best way to treat leukoplakia and prevent future recurrences of it. Regular checkups are important, as is routinely inspecting your mouth for areas that dont look normal. The condition is thought to be caused by irritation, but the cause is not always known. Occasionally, patches develop on the female external genitalia. Biopsy of clinically suspected oral leukoplakia is mandatory to. Read and know what is leukoplakia as well as all about its causes, symptoms, diagnosis, treatment and prevention. Type of surgical treatment and recurrence of oral leukoplakia. Leukoplakia pictures, causes, symptoms, treatment and. Leukoplakia, or white and gray patches inside the mouth, may be caused by irritation. Treatment parameters of 70 patients with premalignant oral epithelial lesions. The appearance of keratinized areas of multilayered epithelium on the mucous membranes suggests leukokeratosis. Aug 05, 2019 oral hairy leukoplakia ohl is a disease of the mucosa first described in 1984.
Proliferative verrucous leukoplakia of the gingiva pvlg appears to be a subset of oral proliferative verrucous leukoplakia. Leukoplakia causes, pictures, symptoms, treatment, prognosis. Insight of various medical management of oral leukoplakia t manigandan 1, vt hemalatha 2 1 research scholar and professor, department of oral medicine and radiology, sree balaji dental college and hospital, bharath university, chennai, india 2 research scholar and reader, department of oral medicine and radiology, sree balaji dental college. Jun 21, 2018 in majority of the cases, leukoplakia goes away on its own and does not require any treatment, but it is important to identify the cause of leukoplakia and staying away from it. Pdf early detection and treatment of speckled leukoplakia. Multifactorial etiology of oral leukoplakia allows speaking not so much about the causes of disease, as much of the circumstances which cause it. However, leukoplakia is not limited as an oral disorder alone, as it may also appear in the genital area of the female. Because of its association with comorbid malignancy, however, treatment is excision or biopsy followed by close followup. Ohl is usually an asymptomatic lesion, but in some cases treatment is recommended to reestablish the normal characteristics of the tongue, to eliminate pathogenic microorganisms, to improve patient comfort and for cosmetic reasons. It can be characterized as a solitary, recurring, progressive white patch that develops a verruciform architecture and may not be associated with hpv. If you have problems viewing pdf files, download the latest version of adobe reader. There are no strict guidelines for the duration and frequency of followup. These white patches form along the gums, inside the cheeks, the bottom of the mouth, andor on the tongue.
Management of potentially malignant disorders wiley online library. Leukoplakia could be classified as mucosal disease, and also as a premalignant condition. There also is no consensus on management or best practice guidelines for the management and treatment of dysplastic lesions, much less. The aim of this paper was to assess the nonsurgical treatment of oral leukoplakia ol. Nov 10, 2016 leukoplakia formerly also applied to vulval lesions but several international societies have developed a standardised nomenclature based on histopathological findings in vulval lesions.
Thirtynine patients had some degree of microscopic dysplasia and six demonstrated high risk proliferative verrucous leukoplakia. Topic alapdt is effective to treat oral leukoplakia, especially for. The goal of treatment is to get rid of the leukoplakia patch. Oral hairy leukoplakia ohl is a disease of the mucosa first described in 1984.
Oral leukoplakia ol is a white patch or plaque of the oral mucosa that cannot be characterised clinically or pathologically as any other conditions such as cheek biting, candidosis, lichen planus and materia alba. Leukoplakia is a condition in which thick, white or grayish patches form usually inside your mouth. Oral leukoplakia is a condition that causes white patches to form inside the mouth. It is not, in and of itself, proved to be a premalignant condition. Symptoms and treatment of cervical leukoplakia, oncology. The primary outcomes of interest were clinical resolution, malignant transformation, followup, and recurrence of ol. Other synergistic risk factors include alcohol consumption, chronic irritation, fungal infections such as candidiasis. Leukoplakia is a condition wherein white or gray patches appear in some parts of the mouth, predominantly in the buccal mucosa and the tongue. Leukoplakia treatment is most successful when a lesion is found and treated early, when its small. Shapshay 35 believed that co 2 laser treatment induces thermal dam. Nov 15, 2011 leukoplakia is a discomforting condition that affects around 3% of the world population. Kanmani2, n megalai3 1department of oral medicine and radiology, indira gandhi institute of dental sciences, pondicherry, india, 2department of oral medicine and radiology, srm. Oral leuoplaia hat is achie ed by surgical treatment nnals of oral aillofacial surgery 2 eb. L size of leukoplakia l 1 size of leukoplakia is leukoplakia, youll likely be evaluated for conditions that may contribute to a weakened immune system.
Mar, 2019 oral leukoplakia ol is a white patch or plaque that cannot be rubbed off, cannot be characterized clinically or histologically as any other condition, and is not associated with any physical or chemical causative agent except tobacco. Oral hairy leukoplakia ohl is a disease associated with epsteinbarr virus and human immunodeficiency virus infections. A biopsy is recommended to determine whether the lesion is precancerous. May 30, 2012 if you have problems viewing pdf files, download the latest version of adobe reader. Postoperative laser therapy treatments n postlaser medications paint clinical appearance no. It develops in the mouth, genital, and in some cases, it is formed in the internal organs. Leukoplakia buccalis, leukokeratosis or smokers patch is one of the most common lesions that one encounters in an examination of the oral cavity. The management of oral leukoplakia varies from a wait and see attitude and topical chemopreventive agents to complete surgical removal. Leukoplakia is the most common premalignant or potentially malignant lesion of the oral mucosa. Removing the source of irritation may cause the patch to disappear. The lesion is usually removed in the health care providers office using local anesthesia.
Treatment consists of surgery with or without additional radiotherapy and. Original article comparison of co laser and conventional 2. Learn more from webmd about how leukoplakia is treated. It seems preferable to use the term leukoplakia as a clinical term only. Yag laser could be a promising option for the treatment of ol. For example, if leukoplakia is caused by a rough tooth or an irregular surface on a denture or filling the tooth will be smoothed and dental appliances repaired. Risk factors include all forms of tobacco use forms including cigar, cigarette, beedi, and pipe. Leukoplakia is a precancerous mucous membrane condition manifested by white patches that develops on the tongue, gums, or the inside of the cheek. Oral cancers commonly develop near leukoplakia patches, and these patches can often show changes that are cancerous. Leukoplakia is a common condition characterized by an increased risk for malignant transformation. But when this is not effective, or the lesions begin to show early indications of cancer, the dentist may refer the individual for treatments that include. When this is not effective or if the lesions show early signs of cancer, treatment may include removing the patches.
However, its treatment of benign laryngeal diseases and precancerous lesions, such as vocal cord polyps, vocal nodules and vocal cord leukoplakia, remain controversial. Leukoplakia treatment for the majority of individuals, quitting alcohol and tobacco use will generally clear the condition. The list of treatments mentioned in various sources for leukoplakia includes the following list. It is defined as essentially an oral mucosal white lesion that cannot be considered as any other definable lesion. Even after you get rid of leukoplakia patches, the risk of oral cancer still stays elevated. Use of carbon dioxide laser for treatment of premalignant lesions of the oral mucosa. Leukoplakia on the vulva is treated in the same way as oral lesions. Hairy leukoplakia is not painful and is not likely to lead to cancer. Although the white color in leukoplakia is a result of hyperkeratosis or acanthosis, similarly appearing white lesions that are caused by reactive keratosis smokers keratosis or frictional keratoses e. Most cervical leukoplakia occursasymptomatic, may cause itching, which leads to the appearance of the calculations and abrasions. Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126 tollfree. Leukoplakia is a predominantly white lesion of the oral mucosa that. Dysplasia, oral leukoplakia, treatment introduction oral leukoplakia is defined as a predominantly white lesion of the oral mucosa that cannot be characterized as any other definable lesion.
This pathology is associated with epsteinbarr virus ebv and occurs mostly in people with hiv, both immunocompromised and immunocompetent, albeit it can affect patients who are hiv negative. Longterm treatment outcome of oral premalignant lesions p. The most effective methods of oral leukoplakia treatment. Lee akst, director laryngology, john hopkins voice center, discusses leukoplakia treatment. Leukoplakia, management, surgical, nonsurgical treatment, introduction oral leukoplakia ol is the most frequent precancerous lesion of the oral cavity. Type of surgical treatment and recurrence of oral leukoplakia ncbi. Always seek professional medical advice about any treatment or. Insight of various medical management of oral leukoplakia. When a biopsy is taken, the term leukoplakia should be replaced by the diagnosis obtained histologically. Primary clinical evaluation of photodynamic therapy. For most people, removing the source of irritation. The main objective in oral leukoplakias management of care is to detect and to prevent malignant transformation. Jan 29, 20 proliferative verrucous leukoplakia is a rare form of ol which has multiple recurrences, is refractory to treatment and has malignant transformation in a short period.