The diagnosis and treatment of precancerous lesions

Leukoplakia is the most common premalignant lesion of the oral mucosa. The term should be used only for white lesions that cannot be characterised as any other definable lesion. The chance of malignant transformation can to some extent be predicted on the basis of the clinical appearance, the oral subsite, and the histopathological findings in the biopsy. The management of patients with oral leukoplakia is primarily directed towards elimination of possible causative factors. If the lesion persists, treatment is recommended in most cases. Of the various available treatment modalities no one is superior to the others. Both treated and untreated patients should be scheduled for long term follow-up, probably life long, with 6-12 month intervals in order to he able to detect possible recurrences in an early stage. Erythroplakia is less common than leukoplakia, but carries a considerably higher risk of malignant transformation. Therefore, erythroplakias should always be removed and subsequently, followed up.