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Urban legends series: oral leukoplakia
P G Arduino1, J Bagan, A K El-Naggar
1Department of Surgical Sciences, Oral Medicine Section, Lingotto Dental School, University of Turin, Italy. paologiacomo.arduino@unito.it
Oral Diseases
|February 6, 2013
Summary
Oral leukoplakia (OL) research reveals no definitive link between tobacco/alcohol and OL development. Most OLs are benign, with few progressing to oral squamous cell carcinoma (OSCC).
Area of Science:
- Oral pathology
- Oncology
- Dermatology
Background:
- Oral leukoplakia (OL) is defined as white plaques of questionable risk after excluding other conditions.
- Controversies surround OL etiology, malignant transformation potential, and classification.
Purpose of the Study:
- To review controversial aspects of oral leukoplakia (OL).
- To clarify the role of tobacco and alcohol, OL transformation rates, prediction of malignancy, and the distinction of proliferative verrucous leukoplakia (PVL).
Main Methods:
- Extensive literature search on oral leukoplakia (OL).
- Analysis of evidence regarding etiology, malignant transformation, and specific subtypes like PVL.
Main Results:
- No definitive evidence links smoked tobacco or alcohol to OL causation.
- The majority of OLs follow a benign course, with limited malignant transformation.
- No validated clinical or biological factors reliably predict malignant transformation.
- Early distinction between multifocal leukoplakia and PVL is impossible; PVL diagnosis relies on clinical progression and recurrence rates.
Conclusions:
- The causal role of tobacco and alcohol in OL remains unproven.
- Most oral leukoplakias (OLs) do not progress to oral squamous cell carcinoma (OSCC).
- Proliferative verrucous leukoplakia (PVL) is best identified by its clinical behavior rather than initial presentation.
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