Leukoplakia and Erythroplakia

Leukoplakia is defined by the World Health Organization as a white patch or plaque that cannot be scraped off or characterized clinically or histopathologically as any other disease.21 Leukoplakia is the most common oral precancer; however, only 2 to 4 percent of leukoplakic lesions are carcinoma.22 The prevalence is approximately 20 to 39 per 1000 persons, affecting males twice as frequently as females. Etiology is unknown, but tobacco, alcohol, ultraviolet radiation, candidiasis, human papillomavirus, tertiary syphilis, and trauma have all been implicated. The most common intraoral site involved is the buccal mucosa. Other sites of involvement include the hard and soft palates, maxillary gingiva, and lip mucosa. Biopsy is mandatory for all persistent leukoplakic lesions, yet most demonstrate no dysplastic changes histologically. Leukoplakic lesions of the floor of the mouth, tongue, and vermilion border are most likely associated with malignancy. Lesions demonstrating dysplastic changes warrant removal.21

Erythroplakia is defined as a red patch that similarly cannot be clinically or pathologically characterized as any other disease. Although erythroplakia is far less common than leukoplakia, it has a far greater potential for dysplastic findings histologically. 22

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