Leukoplakia, lichen planus, and other oral keratoses in 23,616 white Americans over the age of 35 years (original) (raw)
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A man with a 30-year history of oral lesions
The Journal of Evidenced-Based Dental Practice, 2001
70-year-old man was admitted to the clinical service with a complaint of oral lesions that had been present intermittently for more than 30 years. The mucosal changes had begun without specifically known triggering factors and had gradually involved several regions of the oral cavity, including the left and right buccal mucosa, the attached gingiva throughout all regions of his dentate mouth, part of the hard palate, and on the lateral borders of his tongue. Changes had not occurred in the tissue of the floor of the mouth, soft palate, or lips. His symptoms were mild and normally consisted of only slight discomfort during ingestion of salty, spicy, or acidic foods. Over the years, clinical assessment by his dentists had never demonstrated a significant or alarming progression of the lesions. His consultation with a local oral surgeon established a clinical diagnosis of erosive oral lichen planus (OLP), which was confirmed by means of a tissue biopsy. He was then followed up periodically. The patient described many episodes of flares and complete remission of the lesions over the years. In 1992, prior to being admitted to our service, changes on the maxillary attached gingiva in the region of tooth numbers 12 and 13 were observed and biopsied, and a histopathologic diagnosis of proliferative verrucous leukoplakia was established for that lesion. No evidence of malignant transformation was detected in the tissue samples, although mild dysplasia was noted.
Oral Leukoplakia. A Five-Year Follow-Up Study
Mædica, 2023
Background: Oral leukoplakia (OLK) is the most studied oral potentially malignant disorders in the scientific literature. Its malignant transformation (MT) rate varies between 1.1% and 40.8%, depending on the type of study and population group studied. There is no universal agreement to treat or manage these lesions, so it is up to each clinician's experience and expertise in how he/she manages these patients. Objectives: The aim of this retrospective study was to assess the clinical aspects and pattern of evolution of OLK in 30 patients five years or more after the initial diagnosis. Materials and methods: We selected 30 OLK patients from our database. Demographic, clinical and evolutive data was retrieved from the medical files. The following variables were analysed: age and sex, smoking habits, clinical features (form, dimension, site of the lesion), result of mycological examination, treatment and outcomes of the lesions over a follow-up of more than five years. Results: For a follow-up of 119.63 months, we detected a value of 0.2% MT rate per year. Outcomes varied from the complete disappearance of the lesion to recurrence and malignant transformation with a variety of treatment methods applied. Conclusion: Despite the low MT rate for a long follow-up, it is hard to say which treatment method is the best, due to the heterogeneity of the clinical aspects of the lesions and because there is no standardised test method, either genetic testing or immunohistochemical testing. We recommend a varied approach, suitable for each patient's needs and medical context, always when possible histopathological confirmation for grading epithelial dysplasia, which remains the most reliable method of checking the process of malignant transformation.
Oral potentially malignant disorders in a large dental population
Journal of applied oral science : revista FOB
Oral cancer (OC) may be preceded by clinically evident oral potentially malignant disorders (OPMDs). Oral carcinogenesis is a multistep process that begins as epithelial hyperplasia and progresses to oral epithelial dysplasia and finally to fully malignant phenotypes. The aim of our study was to estimate the prevalence of OPMDs in a large population of dental patients. Patients were seen in the Oral Diagnosis and Oral Medicine clinics at Boston University Henry M. Goldman School of Dental Medicine between July 2013 and February 2014 and received a comprehensive oral examination to identify any possible mucosal lesions. Patients with a suspected OPMD (submucous fibrosis, oral lichen planus, leukoplakia and erythroplakia) that did not resolve in 2-3 weeks received a biopsy for definitive diagnosis. Logistic regression models were used to explore the relationship between OPMDs and associated risk factors. A total of 3,142 patients received a comprehensive oral examination [median age: ...
Oral Diseases, 2020
Oral potentially malignant disorders (OPMDs) are associated with an increased risk of occurrence of cancers of the lip or oral cavity. This paper presents an updated report on the nomenclature and the classification of OPMDs, based predominantly on their clinical features, following discussions by an expert group at a workshop held by the World Health Organization (WHO) Collaborating Centre for Oral Cancer in the UK. The first workshop held in London in 2005 considered a wide spectrum of disorders under the term “potentially malignant disorders of the oral mucosa” (PMD) (now referred to as oral potentially malignant disorders: OPMD) including leukoplakia, erythroplakia, proliferative verrucous leukoplakia, oral lichen planus, oral submucous fibrosis, palatal lesions in reverse smokers, lupus erythematosus, epidermolysis bullosa, and dyskeratosis congenita. Any new evidence published in the intervening period was considered to make essential changes to the 2007 classification. In the...
Incidence rates for oral leukoplakia and lichen planus in a Japanese population
BACKGROUND: Data on the incidence rates of potentially malignant diseases of the oral cavity in different populations is meagre. This is the first study to report on the age-specific incidence of oral leukoplakia and oral lichen planus from an industrialized country. METHODS: Annual screening for oral cancer and precancer was undertaken in Municipal Health Centres in Tokoname city, Japan from 1995 to 1998. A total of 9536 volunteers aged 40-95 years participated in this programme. A cohort of 6340 (67%) subjects attended annual mouth examinations following a negative screen result at entry, allowing 13 072 person-years of observations. Some associated risk factors (tobacco and alcohol misuse) and health-related variables were also evaluated. RESULTS: Over a 4-year follow-up period, 18 new oral leukoplakias (all homogenous; 11 idiopathic and seven tobacco-associated) and 24 oral lichen planus (22 reticular, one erythematous and one ulcerative) were detected at screening and confirmed by re-examination at specialist units. The age-adjusted incidence rate for leukoplakia was 409.2 (95% CI: 90.6-727.9) in male and 70.0 (95% CI: 17.9-121.8) in female per 100 000 personyears observations. For lichen planus, the corresponding rates were 59.7 (95% CI: 7.4-112.1) and 188.0 (95% CI: 96.0-280.1). The age-adjusted incidence rate for tobaccoassociated leukoplakia in males was almost 12 times compared with female (560.3 vs. 45.2 per 100 000). Agespecific incidence rates for oral leukoplakia varied by age groups. New oral leukoplakias were more prevalent on gingival/alveolar ridge (33.3%) than in other oral sites, and lichen planus at buccal site (33.3%). Prevalence of smoking habits among those positive for leukoplakia (38.9%) was higher compared with the screen-negatives (26.4%) but these differences did not reach statistical significance (P ¼ 0.232). Regular drinking was not related to occurrence of either oral leukoplakia or oral lichen planus. In cases with diabetes mellitus, relative risk for oral lichen planus adjusted by logistic regression was 6.4 (95% CI: 2.4-17.6), suggesting an association. CONCLUSIONS: The reported incidence rates for oral leukoplakia in this Japanese population are somewhat higher to those reported from India, the risk habits of the two groups being markedly different. The reported rates for oral leukoplakia and lichen planus allow estimation of service needs in specialist oral medicine clinics and for the training of primary care dentists. A high incidence of idiopathic leukoplakia found in this study raises challenges to the strategy of screening high-risk populations aimed at conserving resources. J Oral Pathol Med (2005) 34: 532-9
Potentially Malignant Oral Disorders
Diagnosis and Treatment of Oral Lesions [Working Title]
Most cancerous lesions are derived from potentially malignant oral disorders (PMOD). The World Health Organization (WHO) points out the following lesions as the main PMOD: leukoplakia, erythroplakia, actinic cheilitis, submucous fibrosis, and lichen planus. Leukoplakias are white plaques or spots that cannot be removed by scraping, and these lesions aren't characterized clinically or pathologically like any other diseases. Erythroplakias are red lesions of the oral mucosa that also cannot be characterized clinically or pathologically as another definable disease. Actinic cheilitis is an injury that affects the vermilion of the lower lip and has this anatomical location due to its etiological factor, which is the progressive and excessive exposure to ultraviolet rays of sunlight. Submucous fibrosis is a chronic disease of the mouth that presents as an inflammatory subepithelial reaction, followed by an alteration in the submucous fibroelastic tissue. Lichen planus is a dermatological disease characterized by white patches or striations, symmetrical and bilateral, and its treatment is basically done with topical corticosteroids.
Collegium antropologicum, 2012
The aim of this retrospective study was to determine the frequency and malignant transformation rate of oral lichen planus and leukoplakia in a large group of oral medicine patients. Study included 12 508 patients who were referred between 1998 and 2007 to the Department of Oral Medicine. The frequency of OLP was 4.30%, leukoplakia 1.11%, and combined diagnoses 0.14%. In primary biopsies dysplasia was found in 12.96% of patients with leukoplakia and not in one with OLP and combined lesions. The highest frequency of leukoplakia was found in smokers. Women were found as predominant sufferers of both diseases and their combination. During the observed period often years malignant transformation of OLP was not detected, unlike leukoplakia where it was 0.64%. The frequency of OLP and leukoplakia in our study are comparable to other similar studies. The highest frequency of malignant transformation was observed in those patients who did not respond to our invitation to regular check-up. I...