Materiały źródłowe

• #1 Leukoplakia – Wikipedia

  https://en.wikipedia.org/wiki/Leukoplakia

  Leukoplakia is a diagnosis of exclusion, meaning that which lesions are included depends upon what diagnoses are currently considered acceptable. […] Tissue biopsy is usually indicated to rule out other causes of white patches and also to enable a detailed histologic examination to grade the presence of any epithelial dysplasia. […] The current definition of oral leukoplakia adopted by the World Health Organization is „white plaques of questionable risk having excluded (other) known diseases or disorders that carry no increased risk for cancer”. […] The degree of hyperkeratosis, epithelial thickness (acanthosis/atrophy), dysplasia and inflammatory cell infiltration in the underlying lamina propria are variable. […] The word „dysplasia” generally means „abnormal growth”, and specifically, in the context of oral red or white lesions, refers to microscopic changes („cellular atypia”) in the mucosa that indicate a risk of malignant transformation. […] When dysplasia is present, there is generally an inflammatory cell infiltration in the lamina propria.

• #2 Oral leukoplakia – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/621

  Oral leukoplakia presents as white plaques of questionable risk, diagnosed when other known diseases or disorders that carry no risk for oral cancer have been excluded. […] Certain leukoplakias, particularly nonhomogeneous leukoplakias, such as speckled leukoplakia and proliferative verrucous leukoplakia, have a significant risk of malignant transformation. They require habit intervention and frequent and careful follow-up, often with biopsy confirmation or definition of the biologic nature of the leukoplakia over time. […] An international working group has amended the earlier WHO definition as follows: „The term leukoplakia should be used to recognize white plaques of questionable risk having excluded (other) known diseases or disorders that carry no risk for cancer”. […] Histologic features of both forms of leukoplakia are variable and may include orthokeratosis or parakeratosis of various degrees, mild inflammation, and variable degrees of epithelial dysplasia.

• #3 Leukoplakia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/leukoplakia/diagnosis-treatment/drc-20354411

  Most often, your doctor, dentist or other healthcare professional will find out if you have leukoplakia by: […] Ruling out other possible causes. […] If you have leukoplakia, your doctor will likely test a sample of cells in your mouth for early signs of cancer, called a biopsy: […] An excisional biopsy usually results in a definite diagnosis. […] If the biopsy shows cancer and your doctor removed the entire leukoplakia patch with an excisional biopsy, you may not need more treatment. […] You’re likely to start by seeing your doctor, dentist or other healthcare professional. You may be referred to an oral surgeon or an ear, nose and throat (ENT) specialist for diagnosis and treatment.

• #4 Leukoplakia: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/leukoplakia

  Leukoplakia is usually diagnosed with an oral exam. During an oral exam, your healthcare provider can confirm if the patches are leukoplakia. […] Your healthcare provider may need to do other tests to confirm the cause of your spots. This helps them suggest a treatment that may prevent future patches from developing. […] If a patch looks suspicious, your healthcare provider will do a biopsy. To do a biopsy, they remove a small piece of tissue from one or more of your spots. […] They then send that tissue sample to a pathologist for diagnosis to check for precancerous or cancerous cells.

• #5 Leukoplakia

  https://www.nhs.uk/conditions/leukoplakia/

  Leukoplakia is a white patch or patches in the mouth. If you have a white patch in your mouth that does not go away, get it checked by a dentist or GP. […] If it’s thought you may have leukoplakia, the dentist or GP will look at the patch or patches in your mouth. They will be able to rule out other possible causes, such as a fungal infection of the mouth (oral thrush) or cheek biting. […] You may be referred to a specialist for a biopsy. This is where a small piece of the patch is removed and checked for abnormal cells. […] If you have leukoplakia, there’s a small chance it could progress to mouth cancer over time. This is why it’s important to see a dentist or GP if you have a white patch or patches in your mouth.

• #6 Leukoplakia Patches: Causes, Symptoms, and Treatments

  https://www.webmd.com/oral-health/dental-health-leukoplakia

  Leukoplakia Diagnosis Your doctor or dentist will look at your mouth and try to figure out what’s causing your symptoms. If they think it might be leukoplakia, they may take a sample of your mouth tissue for testing in what’s called a biopsy. This can tell if you have early signs of mouth cancer. There are two methods: […] Excisional biopsies are usually more accurate than oral brush biopsies. In both cases, your doctor will send the sample to a lab for testing.

• #7 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?cat=az&lang=1

  The term leukoplakia was first used in 1877 by Schwimmer to denote any white lesion of the oral cavity. This is the most common precancerous lesion of the oral mucosa. […] Oral leukoplakia is now defined as a predominantly white lesion of the oral mucosa that cannot be characterized as any other definable lesion. […] A provisional clinical diagnosis of oral leukoplakia is made when a lesion at the initial clinical examination cannot be clearly diagnosed as any other definable lesion of the oral mucosa with a white appearance. […] A biopsy examination helps to explore other specific conditions that need exclusion before a white patch is confirmed as a leukoplakia. […] Microscopic evidence of dysplasia is not a prerequisite for the diagnosis of leukoplakia. […] It is diagnosed both by its clinical appearance and by the exclusion of other lesions that present as oral white lesions.

• #8 Leukoplakia – European Association of Oral Medicine

  https://eaom.eu/education/eaom-handbook/leukoplakia/

  Leukoplakia is the most common premalignant or „potentially malignant” lesion of the oral mucosa. […] Based on clinical examinations a provisional diagnosis of leukoplakia is made when the lesion cannot be clearly diagnosed as any other disease of the oral mucosa with a white appearance. A definitive diagnosis is made as a result of the identification, and if possible elimination, of suspected etiological factors and, in the case of persistent lesions, histopathological examination confirm the diagnosis. […] Leukoplakia diagnosis has clinical and histopathological approaches. […] Provisional Clinical Diagnosis: clinical evidence from a single visit, using inspection and palpation as the only diagnostic means. […] Definitive Clinical Diagnosis: clinical evidence obtained by lack of changes after eliminating suspected etiologic factors during a follow-up period of 2-4 weeks (In some cases the time may be longer).

• #9 Oral Leukoplakia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK442013/

  Oral leukoplakia is a white patch or plaque that develops in the oral cavity. The condition is potentially malignant and is strongly associated with tobacco use. […] The etiology of oral leukoplakia is multifactorial, and many causes are idiopathic. The most commonly associated risk factor is the use of tobacco in either smoked or smokeless form. […] The gold standard for diagnosis of leukoplakia is always a biopsy from the site of the lesion, but this procedure needs a qualified health-care provider and is considered as an invasive, painful, expensive, and time-consuming procedure. […] Current developments in oral cancer research have steered to the development and expansion of potentially valuable diagnostic tools at the clinical and micromolecular levels for the timely detection of leukoplakia.

• #10 Leukoplakia: Symptoms, Causes, Diagnosis, and Treatment

  https://www.verywellhealth.com/overview-of-leukoplakia-4586502

  Cancer testing for those with leukoplakia may include: Oral brush biopsy: This is the removal of cells (to be tested for cancer) from the outer surface of the lesions using a small brush that spins. Excisional biopsy: This is the surgical removal of tissue from the patch of leukoplakia (or in some instances the entire plaque) to test for cancer cells. […] If an excisional biopsy is positive, the healthcare provider may make a referral to an oral surgeon or an ear-nose-throat specialist (otolaryngolosist) for oral cancer treatment. […] Treatment of leukoplakia is most effective after early diagnosis.

• #11 Leukoplakia Causes, Symptoms, Types, Cancer & Treatment

  https://www.medicinenet.com/leukoplakia/article.htm

  How is leukoplakia diagnosed? Your healthcare provider conducts an oral examination and may attempt to remove the white areas. If the white patches can be wiped off easily, then it is probably not leukoplakia. A detailed medical history to identify potential risk factors, such as smoking or chewing tobacco, will be noted. […] Sometimes, it may not be easy to know if the spots are leukoplakia or another condition, such as oral thrush, just by looking at them. To establish what is causing the patches, a doctor will need to conduct some tests. […] You may be screened for cancer, and the doctor might look for early warning symptoms and suggest a biopsy. […] A biopsy removes tissue from the body to test for diseases like cancer. […] Cancer screening for people with leukoplakia may involve the following tests: Oral brush biopsy. A small spinning brush is used to remove some cells from the outer surface of the lesion. The collected cells sample are further screened for malignancy.

• #12 Leukoplakia Causes, Symptoms, Types, Cancer & Treatment

  https://www.medicinenet.com/leukoplakia/article.htm

  Excisional biopsy. Surgical excision of some tissue from the leukoplakia lesion is performed and tested for malignancy. Excisional biopsy is a more reliable test to detect cancer than oral brush biopsy. […] If the excisional biopsy report comes positive for cancer, your doctor may refer you to a specialist for further treatment. In some instances, the leukoplakia patch may be so small that it may be eradicated with excisional biopsy. That implies no further active treatment may be necessary other than continuous observation.

• #13 Oral Leukoplakia – OPMDCARE

  https://opmdcare.com/oral-leukoplakia/

  The gold standard procedure to confirm the clinical diagnosis of oral leukoplakia is to perform a representative incisional biopsy of the white patch lesion and send tissue for histopathological analysis. […] Diagnostic biopsy is mandatory to confirm or refute the diagnosis of OL. The biopsy, and the subsequent histopathological examination, allow one to exclude other pathologies which may present as a white patch and assess for candida colonisation within the epithelium. […] Biopsy is necessary to exclude the diagnosis of oral squamous cell carcinoma (OSCC) and to evaluate the presence of and degree of epithelial dysplasia.

• #14 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?cat=az&lang=1

  We advise oral punch or incision biopsy as a routine procedure in the overall evaluation of oral leukoplakia, irrespective of the clinical appearance, to assess the presence of dysplasia and to rule out underlying malignancy. […] Conventional biopsy is recommended for all oral leukoplakia that persists after this period. […] Surface nodularity of lesions, appearance of white or red masses with surface pebbling or ulceration, especially at the margins of the lesions, increased firmness and induration, unexplained haemorrhage and chronic ulcer formation in a preexisting leukoplakia, should herald the suspicion of malignant transformation and warrants prompt biopsy and further management. […] The histological findings in oral leukoplakias are highly variable, ranging from hyperkeratosis and hyperplasia to atrophy and varying grades of dysplasia.

• #15 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?cat=az&lang=1

  The term leukoplakia was first used in 1877 by Schwimmer to denote any white lesion of the oral cavity. This is the most common precancerous lesion of the oral mucosa. […] Oral leukoplakia is now defined as a predominantly white lesion of the oral mucosa that cannot be characterized as any other definable lesion. […] A provisional clinical diagnosis of oral leukoplakia is made when a lesion at the initial clinical examination cannot be clearly diagnosed as any other definable lesion of the oral mucosa with a white appearance. […] A biopsy examination helps to explore other specific conditions that need exclusion before a white patch is confirmed as a leukoplakia. […] Microscopic evidence of dysplasia is not a prerequisite for the diagnosis of leukoplakia. […] It is diagnosed both by its clinical appearance and by the exclusion of other lesions that present as oral white lesions.

• #16 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?cat=az&lang=1

  We advise oral punch or incision biopsy as a routine procedure in the overall evaluation of oral leukoplakia, irrespective of the clinical appearance, to assess the presence of dysplasia and to rule out underlying malignancy. […] Conventional biopsy is recommended for all oral leukoplakia that persists after this period. […] Surface nodularity of lesions, appearance of white or red masses with surface pebbling or ulceration, especially at the margins of the lesions, increased firmness and induration, unexplained haemorrhage and chronic ulcer formation in a preexisting leukoplakia, should herald the suspicion of malignant transformation and warrants prompt biopsy and further management. […] The histological findings in oral leukoplakias are highly variable, ranging from hyperkeratosis and hyperplasia to atrophy and varying grades of dysplasia.

• #17 Oral leukoplakia: an update for dental practitioners | Published in Journal of the Irish Dental Association

  https://jida.scholasticahq.com/article/93880-oral-leukoplakia-an-update-for-dental-practitioners

  Upon receipt of a referral for an oral leukoplakia in a specialist unit, the patient will be assessed and will likely proceed to biopsy. Histological examination is important, firstly to exclude other conditions that can present as a white patch (e.g., lichen planus, chronic hyperplastic candidiasis), and secondly to determine the presence and degree of epithelial dysplasia. […] The degree of dysplasia is regarded as the most important determinant for progression to invasive carcinoma, with the risk of malignant transformation increasing with increasing degrees of OED. […] The presence of redness or nodularity in an oral leukoplakia is associated with a greater risk of developing carcinoma and these are red flags for GDPs to be aware of, as they require urgent referral. […] Currently, no consensus exists on the management of oral leukoplakia, and the management algorithm is dictated by a combination of patient, clinical, and histological factors, through a shared decision-making process.

• #18 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?cat=az&lang=1

  Non-homogeneous leukoplakias are more likely to harbour dysplasia as compared to homogeneous leukoplakia. […] The criteria used for diagnosis of dysplasia is given in table 2. […] The histologic assessment of oral epithelial dysplasia is notoriously unreliable, challenging and variable. […] A higher risk of malignant transformation is observed in non-homogeneous leukoplakia compared to homogeneous leukoplakia. […] All leukoplakias should be viewed with suspicion because even small, subtle lesions can manifest significant dysplasia or harbour unsuspected carcinoma.

• #19 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?lang=1&cat=Az

  The histologic assessment of oral epithelial dysplasia is notoriously unreliable, challenging and variable. […] Studies have shown that p53 protein over-expression and other molecular markers such as loss of heterozygosity and DNA ploidy are strong predictors of malignant transformation. […] To date no molecular marker or panel of markers has been identified to specifically predict the malignant potential of leukoplakia.

• #20

  https://link.springer.com/article/10.1007/s40496-019-0204-8

  Ideally, a diagnosis of oral leukoplakia should be the result of close collaboration between clinicians and pathologists, at least when a biopsy or surgical specimen is available. […] In general, lifelong follow-up visits are advised both in treated and untreated patients. […] The recommended time interval as reported in the literature varies from several months up to 1 year. […] The increased morbidity in such instances should be properly weighted against the expected benefit of the treatment. […] Given these shortcomings, there is a strong need for an international consensus meeting to improve the present definition of oral leukoplakia and to agree on uniform reporting of treatment results.

• #21 2025 ICD-10-CM Diagnosis Code K13.21: Leukoplakia of oral mucosa, including tongue

  https://www.icd10data.com/ICD10CM/Codes/K00-K95/K00-K14/K13-/K13.21

  K13.21 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. […] The diagnosis of leukoplakia is one of exclusion; other conditions such as candidiasis, lichen planus, leukoedema, etc. Must be ruled out before a diagnosis of leukoplakia can be made. Leukoplakia may be a premalignant condition. […] A white patch seen on the oral mucosa. It is considered a premalignant condition and is often tobacco-induced. When evidence of epstein-barr virus is present, the condition is called hairy leukoplakia (leukoplakia, hairy). […] White patch seen on the oral mucosa; considered a premalignant condition and is often tobacco-induced.

• #22 Recognizing and Treating Oral Leukoplakia in Primary Care

  https://www.clinicaladvisor.com/home/topics/smoking-tobacco-information-center/recognizing-treating-oral-leukoplakia-primary-care/

  Researchers outline diagnostic and treatment options for oral leukoplakia including use of carbon dioxide (CO2) laser therapy. […] The differential diagnosis should include oral candidiasis, oral lichen planus, oral erythroplakia, oral hairy leukoplakia, or nicotine stomatitis in smokers. […] Once other causes of white plaques have been ruled out through noninvasive testing, biopsy can be performed for a definitive diagnosis. […] A biopsy can also determine if the white lesion is benign, dysplastic, or has transformed to in situ or invasive carcinoma. […] Although brush biopsy, in which a brush is swept along the lesion to collect cells, may be performed before surgical biopsy, evidence of the accuracy of this technique is mixed.

• #23 Hairy Leukoplakia Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/279269-workup

  In most cases of oral hairy leukoplakia (OHL), the diagnosis is established on clinical basis, while a definitive diagnosis requires both an appropriate histopathological appearance and the demonstration of Epstein-Barr virus (EBV) DNA, RNA, or protein within the epithelial cells of the lesion. […] Although these characteristic histologic features of hairy leukoplakia are highly suggestive of the diagnosis, none is unique to the lesion. Thus, a definitive diagnosis of hairy leukoplakia requires both an appropriate histologic/cytologic appearance and demonstration of Epstein-Barr virus (EBV) DNA, RNA, or protein within the epithelial cells of the lesion.

• #24 Hairy leukoplakia

  https://dermnetnz.org/topics/oral-hairy-leukoplakia

  Oral hairy leukoplakia may be suspected in an immunocompromised patient with the typical clinical features and no other cause for oral leukoplakia identified. […] The diagnosis should be confirmed on biopsy and virologic studies such as immunohistochemistry, in-situ hybridisation, or electron microscopy. […] In-situ hybridisation for EBV DNA or RNA can also be performed on a surface scraping or smear.

• #25 Oral leukoplakia – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/621

  1st investigations to order include incisional biopsy. […] Investigations to consider include brush biopsy, autoantibodies for anti-nuclear antibody (ANA), double-stranded DNA, and Smith antigen, and Treponema pallidum serology. […] Emerging tests include chemiluminescent spectroscopy, molecular and chromosomal markers, photodynamic diagnosis (PDD) using 5-aminolevulinic acid (ALA-PDD), and vital staining with toluidine blue.

• #26 Oral leukoplakia – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/621

  Key diagnostic factors include homogeneous white plaques, other causes for white lesions excluded, and nonhomogeneous appearance. […] 1st tests to order include incisional biopsy. […] Emerging tests include chemiluminescent spectroscopy, molecular and chromosomal markers, photodynamic diagnosis (PDD) using 5-aminolevulinic acid (ALA-PDD), and vital staining with toluidine blue.

• #27 Oral Leukoplakia Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/853864-workup

  A definitive diagnosis of oral leukoplakia is made when any etiologic cause other than tobacco/areca nut use has been excluded and histopathology has not confirmed any other specific disorder. […] Biopsy obtainment, repeated as necessary, is essential. […] Yang et al analyzed the relationship between clinical features of OL using endoscopy with narrow-band imaging histopathology. They concluded that flexible endoscopy can be a successful tool for examining OL. […] Molecular markers that may indicate an increased likelihood of malignant transformation are (1) Mutations in the p53 gene, (2) Inappropriate expression of oncogenes (eg, cyclin D1), keratins, blood-group antigens and other cell-surface carbohydrates, and (3) DNA aneuploidy (when the amount of DNA is not an exact multiple of the diploid number).

• #28 Oral Leukoplakia Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/853864-workup

  A definitive diagnosis of oral leukoplakia is made when any etiologic cause other than tobacco/areca nut use has been excluded and histopathology has not confirmed any other specific disorder. […] Biopsy obtainment, repeated as necessary, is essential. […] Yang et al analyzed the relationship between clinical features of OL using endoscopy with narrow-band imaging histopathology. They concluded that flexible endoscopy can be a successful tool for examining OL. […] Molecular markers that may indicate an increased likelihood of malignant transformation are (1) Mutations in the p53 gene, (2) Inappropriate expression of oncogenes (eg, cyclin D1), keratins, blood-group antigens and other cell-surface carbohydrates, and (3) DNA aneuploidy (when the amount of DNA is not an exact multiple of the diploid number).

• #29 Oral Leukoplakia Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/853864-workup

  A study by Sakata et al indicated that a combination of low expression of the tumor suppressor SMAD4 and high stromal lymphocyte infiltration is predictive for the malignant transformation of OL. […] A study by von Zeidler et al suggested that reductions in the amount of epithelial cadherin (E-cadherin), a cellular adhesion protein, signal an increased risk of malignant transformation by OL. […] A study by Habiba et al indicated that expression of aldehyde dehydrogenase 1 and the transmembrane protein podoplanin are associated with a 3.02- and 2.62-fold increase, respectively, in the likelihood that OL will progress to oral cancer. […] A study by Gissi et al also found evidence of a relationship between podoplanin expression and dysplasia in OL.

• #30 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?lang=1&cat=Az

  The histologic assessment of oral epithelial dysplasia is notoriously unreliable, challenging and variable. […] Studies have shown that p53 protein over-expression and other molecular markers such as loss of heterozygosity and DNA ploidy are strong predictors of malignant transformation. […] To date no molecular marker or panel of markers has been identified to specifically predict the malignant potential of leukoplakia.

• #31

  https://link.springer.com/article/10.1007/s40496-019-0204-8

  Leukoplakia is a predominantly white lesion of the oral mucosa that carries an increased risk of malignant transformation. […] To provide insight into the difficulties in arriving at a proper diagnosis, (2) to evaluate the latest research on (bio) markers that may have predictive value with regard to the risk of malignant transformation, and (3) to evaluate the latest research on how patients with oral leukoplakia should be managed. […] Based on the present definition, a diagnosis of leukoplakia is one by exclusion of known, well-defined lesions and disorders that may occur in the oral mucosa. […] At present, there are no molecular markers or set of markers that would more accurately result in a proper diagnosis of oral leukoplakia. […] The histopathological findings in oral leukoplakia range from hyperkeratosis without epithelial dysplasia to various degrees of epithelial dysplasia.

• #32 Oral Leukoplakia: Diagnosis And Management Revisited

  https://scholarhub.ui.ac.id/jdi/vol30/iss2/1/

  The definition of oral leukoplakia has not much changed during the past five decades and is still a definition by exclusion of known lesions. Therefore, a diagnosis of leukoplakia is not always a straightforward one for the clinicians and, to some extent, also for the pathologists. […] The presence and grade of epithelial dysplasia as assessed by histopathological examination is still the most important one. […] There is a strong need for randomized prospective studies and uniform reporting of treatment results. […] Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions. […] Diagnostic accuracy of colposcopic examination in patients with oral dysplastic lesions. […] Oral premalignant lesions: Is a biopsy reliable?

• #33

  https://link.springer.com/article/10.1007/s40496-019-0204-8

  Ideally, a diagnosis of oral leukoplakia should be the result of close collaboration between clinicians and pathologists, at least when a biopsy or surgical specimen is available. […] In general, lifelong follow-up visits are advised both in treated and untreated patients. […] The recommended time interval as reported in the literature varies from several months up to 1 year. […] The increased morbidity in such instances should be properly weighted against the expected benefit of the treatment. […] Given these shortcomings, there is a strong need for an international consensus meeting to improve the present definition of oral leukoplakia and to agree on uniform reporting of treatment results.

• #34 Proliferative verrucous leukoplakia: diagnosis, management and current advances | Brazilian Journal of Otorhinolaryngology

  https://www.elsevier.es/en-revista-brazilian-journal-otorhinolaryngology-english-edition–497-articulo-proliferative-verrucous-leukoplakia-diagnosis-management-S1808869417300058

  Proliferative verrucous leukoplakia is a multifocal and progressive lesion of the oral mucosa, with unknown etiology, and commonly resistant to all therapy attempts with frequent recurrences. […] There are not enough studies about Proliferative verrucous leukoplakia in the literature. The few found studies not present a consensus about its etiology and diagnosis criteria. […] Although there are published papers about PVL diagnosis criteria, they may be imprecise in detecting early disease presentations, either for clinical or histopathological view. […] Hansen et al. (1985) determined that lesions diagnosed as PVL could have initially a homogeneous aspect, without dysplasia, followed by warty appearance of surface areas and multiple discrete or confluent lesions in single or multiple intra-oral sites.

• #35 Proliferative verrucous leukoplakia: diagnosis, management and current advances | Brazilian Journal of Otorhinolaryngology

  https://www.elsevier.es/en-revista-brazilian-journal-otorhinolaryngology-english-edition–497-articulo-proliferative-verrucous-leukoplakia-diagnosis-management-S1808869417300058

  According to Cerero-Lapiedra et al. (2010), studies published on PVL followed the diagnostic criterion postulated by Hansen et al. (1985). […] To PVL diagnosis, patient should have one of the following combinations: Three major criteria (one of which must include the evolution of the histopathological lesions). […] Two major criteria (one of which must include the evolution of the histopathological lesions)+two minor criteria. […] Bagan et al. (2011) believed that these criteria are useful only for those with clinical experience with PVL, but can be confusing for beginners. […] Corroborating with this observation, Carrard et al. (2013) suggested simplifying the diagnostic criteria by omitting the distinction between major and minor criteria. However, all four criteria should be met.

• #36 Proliferative verrucous leukoplakia: diagnosis, management and current advances | Brazilian Journal of Otorhinolaryngology

  https://www.elsevier.es/en-revista-brazilian-journal-otorhinolaryngology-english-edition–497-articulo-proliferative-verrucous-leukoplakia-diagnosis-management-S1808869417300058

  According to Cerero-Lapiedra et al. (2010), studies published on PVL followed the diagnostic criterion postulated by Hansen et al. (1985). […] To PVL diagnosis, patient should have one of the following combinations: Three major criteria (one of which must include the evolution of the histopathological lesions). […] Two major criteria (one of which must include the evolution of the histopathological lesions)+two minor criteria. […] Bagan et al. (2011) believed that these criteria are useful only for those with clinical experience with PVL, but can be confusing for beginners. […] Corroborating with this observation, Carrard et al. (2013) suggested simplifying the diagnostic criteria by omitting the distinction between major and minor criteria. However, all four criteria should be met.

• #37 Proliferative verrucous leukoplakia: diagnosis, management and current advances | Brazilian Journal of Otorhinolaryngology

  https://www.elsevier.es/en-revista-brazilian-journal-otorhinolaryngology-english-edition–497-articulo-proliferative-verrucous-leukoplakia-diagnosis-management-S1808869417300058

  Proliferative verrucous leukoplakia is a multifocal and progressive lesion of the oral mucosa, with unknown etiology, and commonly resistant to all therapy attempts with frequent recurrences. […] There are not enough studies about Proliferative verrucous leukoplakia in the literature. The few found studies not present a consensus about its etiology and diagnosis criteria. […] Although there are published papers about PVL diagnosis criteria, they may be imprecise in detecting early disease presentations, either for clinical or histopathological view. […] Hansen et al. (1985) determined that lesions diagnosed as PVL could have initially a homogeneous aspect, without dysplasia, followed by warty appearance of surface areas and multiple discrete or confluent lesions in single or multiple intra-oral sites.

• #38 Proliferative verrucous leukoplakia: diagnosis, management and current advances | Brazilian Journal of Otorhinolaryngology

  https://www.elsevier.es/en-revista-brazilian-journal-otorhinolaryngology-english-edition–497-articulo-proliferative-verrucous-leukoplakia-diagnosis-management-S1808869417300058

  Proliferative verrucous leukoplakia is a multifocal and progressive lesion of the oral mucosa, with unknown etiology, and commonly resistant to all therapy attempts with frequent recurrences. […] There are not enough studies about Proliferative verrucous leukoplakia in the literature. The few found studies not present a consensus about its etiology and diagnosis criteria. […] Although there are published papers about PVL diagnosis criteria, they may be imprecise in detecting early disease presentations, either for clinical or histopathological view. […] Hansen et al. (1985) determined that lesions diagnosed as PVL could have initially a homogeneous aspect, without dysplasia, followed by warty appearance of surface areas and multiple discrete or confluent lesions in single or multiple intra-oral sites.

• #39 Leukoplakia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/leukoplakia/diagnosis-treatment/drc-20354411

  Most often, your doctor, dentist or other healthcare professional will find out if you have leukoplakia by: […] Ruling out other possible causes. […] If you have leukoplakia, your doctor will likely test a sample of cells in your mouth for early signs of cancer, called a biopsy: […] An excisional biopsy usually results in a definite diagnosis. […] If the biopsy shows cancer and your doctor removed the entire leukoplakia patch with an excisional biopsy, you may not need more treatment. […] You’re likely to start by seeing your doctor, dentist or other healthcare professional. You may be referred to an oral surgeon or an ear, nose and throat (ENT) specialist for diagnosis and treatment.

• #40 Oral leukoplakia: an update for dental practitioners | Published in Journal of the Irish Dental Association

  https://jida.scholasticahq.com/article/93880-oral-leukoplakia-an-update-for-dental-practitioners

  The primary objective for treatment is the prevention of transformation into OSCC, considering the poor prognosis of OSCC and the considerable morbidity associated with its management. […] While there is an elevated risk of OSCC developing from oral leukoplakia, many leukoplakias do not progress to carcinoma. […] Patients must be informed that progression of oral leukoplakia to malignancy can occur and that recurrence of oral leukoplakia following excision is possible. […] Given that it may take up to ten years for oral carcinoma to develop from oral leukoplakia, long-term follow-up is considered best practice, at three- to 12-month intervals, depending on the degree of OED and other risk factors. […] Oral leukoplakia rarely presents with any symptoms, which can lead to delayed diagnosis.

• #41 Oral leukoplakia: an update for dental practitioners | Published in Journal of the Irish Dental Association

  https://jida.scholasticahq.com/article/93880-oral-leukoplakia-an-update-for-dental-practitioners

  Upon receipt of a referral for an oral leukoplakia in a specialist unit, the patient will be assessed and will likely proceed to biopsy. Histological examination is important, firstly to exclude other conditions that can present as a white patch (e.g., lichen planus, chronic hyperplastic candidiasis), and secondly to determine the presence and degree of epithelial dysplasia. […] The degree of dysplasia is regarded as the most important determinant for progression to invasive carcinoma, with the risk of malignant transformation increasing with increasing degrees of OED. […] The presence of redness or nodularity in an oral leukoplakia is associated with a greater risk of developing carcinoma and these are red flags for GDPs to be aware of, as they require urgent referral. […] Currently, no consensus exists on the management of oral leukoplakia, and the management algorithm is dictated by a combination of patient, clinical, and histological factors, through a shared decision-making process.

• #42 Oral leukoplakia: an update for dental practitioners | Published in Journal of the Irish Dental Association

  https://jida.scholasticahq.com/article/93880-oral-leukoplakia-an-update-for-dental-practitioners

  Upon receipt of a referral for an oral leukoplakia in a specialist unit, the patient will be assessed and will likely proceed to biopsy. Histological examination is important, firstly to exclude other conditions that can present as a white patch (e.g., lichen planus, chronic hyperplastic candidiasis), and secondly to determine the presence and degree of epithelial dysplasia. […] The degree of dysplasia is regarded as the most important determinant for progression to invasive carcinoma, with the risk of malignant transformation increasing with increasing degrees of OED. […] The presence of redness or nodularity in an oral leukoplakia is associated with a greater risk of developing carcinoma and these are red flags for GDPs to be aware of, as they require urgent referral. […] Currently, no consensus exists on the management of oral leukoplakia, and the management algorithm is dictated by a combination of patient, clinical, and histological factors, through a shared decision-making process.

• #43 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?cat=az&lang=1

  We advise oral punch or incision biopsy as a routine procedure in the overall evaluation of oral leukoplakia, irrespective of the clinical appearance, to assess the presence of dysplasia and to rule out underlying malignancy. […] Conventional biopsy is recommended for all oral leukoplakia that persists after this period. […] Surface nodularity of lesions, appearance of white or red masses with surface pebbling or ulceration, especially at the margins of the lesions, increased firmness and induration, unexplained haemorrhage and chronic ulcer formation in a preexisting leukoplakia, should herald the suspicion of malignant transformation and warrants prompt biopsy and further management. […] The histological findings in oral leukoplakias are highly variable, ranging from hyperkeratosis and hyperplasia to atrophy and varying grades of dysplasia.

• #44 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?cat=az&lang=1

  We advise oral punch or incision biopsy as a routine procedure in the overall evaluation of oral leukoplakia, irrespective of the clinical appearance, to assess the presence of dysplasia and to rule out underlying malignancy. […] Conventional biopsy is recommended for all oral leukoplakia that persists after this period. […] Surface nodularity of lesions, appearance of white or red masses with surface pebbling or ulceration, especially at the margins of the lesions, increased firmness and induration, unexplained haemorrhage and chronic ulcer formation in a preexisting leukoplakia, should herald the suspicion of malignant transformation and warrants prompt biopsy and further management. […] The histological findings in oral leukoplakias are highly variable, ranging from hyperkeratosis and hyperplasia to atrophy and varying grades of dysplasia.

• #45 Oral leukoplakia: an update for dental practitioners | Published in Journal of the Irish Dental Association

  https://jida.scholasticahq.com/article/93880-oral-leukoplakia-an-update-for-dental-practitioners

  The primary objective for treatment is the prevention of transformation into OSCC, considering the poor prognosis of OSCC and the considerable morbidity associated with its management. […] While there is an elevated risk of OSCC developing from oral leukoplakia, many leukoplakias do not progress to carcinoma. […] Patients must be informed that progression of oral leukoplakia to malignancy can occur and that recurrence of oral leukoplakia following excision is possible. […] Given that it may take up to ten years for oral carcinoma to develop from oral leukoplakia, long-term follow-up is considered best practice, at three- to 12-month intervals, depending on the degree of OED and other risk factors. […] Oral leukoplakia rarely presents with any symptoms, which can lead to delayed diagnosis.

• #46 Understanding Oral Leukoplakia: Diagnosis, Treatment, and Prevent

  https://www.primescholars.com/articles/understanding-oral-leukoplakia-diagnosis-treatment-and-prevention-of-white-lesions-in-the-mouth-130576.html

  Oral leukoplakia is a common oral mucosal lesion characterized by white or grey patches that cannot be scraped off, typically appearing on the mucous membranes of the mouth, including the tongue, cheeks, gums, and floor of the mouth. […] Diagnosis of oral leukoplakia involves a thorough clinical examination by a dental or medical professional, often supplemented by biopsy and histopathological analysis to confirm the presence of dysplasia or malignant transformation. […] Given its potential for malignant transformation, oral leukoplakia underscores the importance of regular dental examinations and early detection of potentially concerning oral lesions. […] Diagnosis involves a thorough clinical examination, often supplemented by biopsy and histopathological analysis to confirm the presence of dysplasia or malignant transformation. […] Early detection, thorough clinical examination, and histopathological analysis are crucial for accurate diagnosis and management.

• #47 Understanding Oral Leukoplakia: Diagnosis, Treatment, and Prevent

  https://www.primescholars.com/articles/understanding-oral-leukoplakia-diagnosis-treatment-and-prevention-of-white-lesions-in-the-mouth-130576.html

  Oral leukoplakia is a common oral mucosal lesion characterized by white or grey patches that cannot be scraped off, typically appearing on the mucous membranes of the mouth, including the tongue, cheeks, gums, and floor of the mouth. […] Diagnosis of oral leukoplakia involves a thorough clinical examination by a dental or medical professional, often supplemented by biopsy and histopathological analysis to confirm the presence of dysplasia or malignant transformation. […] Given its potential for malignant transformation, oral leukoplakia underscores the importance of regular dental examinations and early detection of potentially concerning oral lesions. […] Diagnosis involves a thorough clinical examination, often supplemented by biopsy and histopathological analysis to confirm the presence of dysplasia or malignant transformation. […] Early detection, thorough clinical examination, and histopathological analysis are crucial for accurate diagnosis and management.

• #48 Understanding Oral Leukoplakia: Diagnosis, Treatment, and Prevent

  https://www.primescholars.com/articles/understanding-oral-leukoplakia-diagnosis-treatment-and-prevention-of-white-lesions-in-the-mouth-130576.html

  Oral leukoplakia is a common oral mucosal lesion characterized by white or grey patches that cannot be scraped off, typically appearing on the mucous membranes of the mouth, including the tongue, cheeks, gums, and floor of the mouth. […] Diagnosis of oral leukoplakia involves a thorough clinical examination by a dental or medical professional, often supplemented by biopsy and histopathological analysis to confirm the presence of dysplasia or malignant transformation. […] Given its potential for malignant transformation, oral leukoplakia underscores the importance of regular dental examinations and early detection of potentially concerning oral lesions. […] Diagnosis involves a thorough clinical examination, often supplemented by biopsy and histopathological analysis to confirm the presence of dysplasia or malignant transformation. […] Early detection, thorough clinical examination, and histopathological analysis are crucial for accurate diagnosis and management.

Zobacz więcej