4.3.1 Leukoplakia

Definition

White adherent mucosal changes, reflecting increased or abnormal keratinisation of the stratified squamous (normally not keratinised) mucosal epithelium of the mouth or transitional epithelium (lips, penis).

Aetiology & Pathogenesis

Based on cause. Exogenous: chemical (tobacco) or mechanical irritation (abnormal teeth, dentures), also hereditary.

Signs & Symptoms

Asymptomatic white plaques.

Localisation

Anywhere in the mouth, especially buccal or sublingual mucosa; also genital or anal mucosa.

Laboratory & other workups

Unremarkable.

Dermatopathology

Epithelial hyperplasia with or without atypia.

Course

Chronic, can evolve into carcinoma.

Diagnosis

Clinical features; if persistent or infiltrated histology is mandatory.

Differential diagnosis

Prevention & Therapy

Clinical follow-up, eliminating irritating factors, in some instances oral retinoids or excision.

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