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https://upload.medbullets.com/topic/122013/images/leukoplakia.jpg
Snapshot
  • A 66-year-old man presents to his primary care physician with oral lesions. He is not sure when his symptoms began, but he denies any trauma to his oral mucosa. He endorses smoking 1 pack of cigarettes daily for the past 45 years and drinks socially. Physical examination is notable for white plaques in the oral mucosa that do not scrape off. He is referred for biopsy.
Introduction
  • Overview
    • oral mucosal white patches with malignancy potential that cannot be scraped off
  • Epidemiology
    • risk factors
      • tobacco use
      • alcohol use 
      • human papillomavirus (HPV) infection
  • Pathophysiology
    • unclear
  • Associated conditions
    • squamous cell carcinoma
  • Prognosis
    • may recur or progress to squamous cell carcinoma desipite surgical removal
Presentation
  • Physical exam
    • oral plaques that cannot be scraped off 
Studies
  • Biopsy
    • indication
      • confirms the diagnosis and determines the degree of dysplasia
Differential
  • Oral hairy leukplakia
    • differentiating factors
      • seen in immunocompromised patients and caused by Epstein-Barr virus
  • Pseudomembranous candidiasis
    • differentiating factors
      • can be scraped off
Treatment
  • Conservative and lifestyle
    • smoking and alcohol cessation
      • indication
        • initial management
    • monitoring
      • indication
        • to assess recurrence 
  • Surgical and interventional
    • surgical removal
      • indication
        • for small and clinically nonhomogenous lesions
Complications
  • Recurrence
  • Squamous cell carcinoma

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