eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Head & Neck Surgery
Oral Leukoplakia, Idiopathic: Treatment & Medication
Updated: Feb 7, 2008
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Treatment
Medical Care
Surgical excision of oral leukoplakia (OL) may be considered. Frequent clinical observation accompanied by photographic records is recommended. Because of the unpredictable behavior of dysplastic lesions, immediately obtain a biopsy on any areas that are suggestive or that change in appearance. Cryotherapy ablation and carbon dioxide laser ablation are also used. The area heals rapidly, and apparently healthy mucosa is left behind. However, uncertainty remains regarding the risk of invasive carcinomas subsequently arising in sites previously treated.
Consultations
Consult an oral medicine specialist to evaluate etiologic factors and to determine the individualized treatment.
Diet
Discontinue the use of alcohol.
Activity
Physical activity is not restricted.
Medication
Topical retinoids are ineffective. Systemic retinoids may be effective, but they have toxic effects. Studies that investigated the use of a high-dose induction followed by low-dose systemic isotretinoin report stabilization of the majority of lesions, a more effective response than beta-carotene in preventing malignant changes, and no toxicity.4 Recently, studies report that beta-carotene produced sustained remissions in patients with oral leukoplakia (OL), with a durable response for at least 1 year.5 Both of these drugs have been used in experimental trials and must be investigated in more depth.
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Treatment & Medication: Oral Leukoplakia, Idiopathic |
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References
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Greenspan D, Jordan RC. The white lesion that kills--aneuploid dysplastic oral leukoplakia. N Engl J Med. Apr 1 2004;350(14):1382-4. [Medline].
Sudbø J, Lippman SM, Lee JJ, Mao L, Kildal W, Sudbø A. The influence of resection and aneuploidy on mortality in oral leukoplakia. N Engl J Med. Apr 1 2004;350(14):1405-13. [Medline].
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Garewal HS, Katz RV, Meyskens F, Pitcock J, Morse D, Friedman S. Beta-carotene produces sustained remissions in patients with oral leukoplakia: results of a multicenter prospective trial. Arch Otolaryngol Head Neck Surg. Dec 1999;125(12):1305-10. [Medline].
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Eveson JW. Oral premalignancy. Cancer Surv. 1983;2:403-424.
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Laskaris G. Color Atlas of Oral Diseases in Children and Adolescents. New York, NY: Thieme Medical;2000.
Mincer HH, Coleman SA, Hopkins KP. Observations on the clinical characteristics of oral lesions showing histologic epithelial dysplasia. Oral Surg Oral Med Oral Pathol. Mar 1972;33(3):389-99. [Medline].
Pindborg JJ, Roed-Peterson B, Renstrup G. Role of smoking in floor of the mouth leukoplakias. J Oral Pathol. 1972;1(1):22-9. [Medline].
Shafer WG, Hine MK, Levy BM, eds. A Textbook of Oral Pathology. 4th ed. Philadelphia, Pa: WB Saunders;1983.
Silverman S Jr, Gorsky M, Lozada F. Oral leukoplakia and malignant transformation. A follow-up study of 257 patients. Cancer. Feb 1 1984;53(3):563-8. [Medline].
Silverman S, Bhargava K, Smith LW, Malaowalla AM. Malignant transformation and natural history of oral leukoplakia in 57,518 industrial workers of Gujarat, India. Cancer. Oct 1976;38(4):1790-5. [Medline].
Warnakulasuriya S, Johnson NW, van der Waal I. Nomenclature and classification of potentially malignant disorders of the oral mucosa. J Oral Pathol Med. 2007;36:575-580.
Further Reading
Keywords
oral leukoplakia, OL, focal keratosis, hyperkeratosis, mouth cancer, leukoplakia, oral plaque, mouth plaque, idiopathic leukoplakia, idiopathic oral leukoplakia, premalignant oral lesion, premalignant mouth lesion, precancerous lesion, speckled leukoplakia, verrucous leukoplakia, homogenous leukoplakia, speckled OL, verrucous OL, homogenous OL
Treatment & Medication: Oral Leukoplakia, Idiopathic