Treatment of oral leukoplakia with topical bleomycin. A pilot study

Leukoplakia is a clinical diagnosis with the potential for malignant transformation. This pilot study tested the use of bleomycin a as topical agent for the treatment of leukoplakia. Twelve patients were enrolled in this study, each for 2 weeks of daily topical application of bleomycin in dimethylsulphoxide (DMSO) painted over the lesion. Two patients were excluded from analysis due to excessive dilution of the medication by local saliva production. Five patients were treated with a 0.5% solution that caused a decrease in the thickness of all of the lesions clinically. One lesion also had a sharp decrease in size. Five patients were treated with a 1.0% solution that caused a complete resolution of the lesions in three patients. Two lesions demonstrated maturation of parakeratosis to keratosis only. All patients tolerated the treatments well. Topical bleomycin may play a role in the treatment of leukoplakia and warrants further investigation.