Clinico-Pathologic Evaluation & Medical Treatment of Oral Leukoplakia

Leukoplakia is defined as a predominantly white lesion of the oral mucosa that cannot be characterized as any other definable lesion. Histopathological diagnosis is needed to evaluate prognosis of this lesion. Chewing tobacco and smoking are distinct risk factors particularly among males in certain countries; however it has been noted that females or non-smokers may be at risk of malignant transformation. HPV has been detected in oral dysplasia lesions and cancer in non-smokers. Malignant transformation rates of oral leukoplakia (OL) range from 0.13 to 17.5%, while the rates of five year cumulative malignant transformation range from 1.2 to 14.5%. Although the administration of retinoic acid and beta-carotene has some efficacy to resolve OL, the role of photodynamic therapy (PDT) is believed to play an important therapeutic role in these patients. This article emphasizes need of uniform classification methods to evaluate the malignant potential of leukoplakia, and new treatment avenues in its resolution.