[A white lesion of the oral mucosa: leukoplakia?]

In three patients, two men aged 50 and 44 years and a woman aged 56 years, an apparently identical white lesion of the oral mucosa was found. The first patient appeared to have an irritation due to vigorous toothbrushing, which disappeared after reducing the brushing frequency and using a soft brush, the second patient had a lichen planus, for which a wait and see policy was adopted, and the third patient had verrucous hyperplasia with dysplasia which was treated by CO2-laser evaporation. Oral leukoplakia occurs frequently together with other white lesions. Leukoplakia is a diagnosis by exclusion and the term should be used as a clinical diagnosis only. When a biopsy is taken, the term leukoplakia is replaced by the diagnosis obtained histologically. About 5% of leukoplakias progress to cancer in a mean observation period of 5 years. Sufficient knowledge of the nomenclature and clinical characteristics of oral white lesions may contribute to the prevention of malignancies and unnecessary referral to a medical specialist.