Dermatologic Manifestations of Oral Leukoplakia Treatment & Management

Updated: Mar 10, 2022
  • Author: James J Sciubba, DMD, PhD; Chief Editor: William D James, MD  more...
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Treatment

Medical Care

The objective of care is to detect and to prevent malignant change. The presence of the white plaque alone does not require treatment.

Possible courses of action include the following:

  • Remove any precipitating factors

  • Medical therapies (eg, anti-inflammatory agents, vitamins, cytotoxic agents) [35]

  • Surgical removal (eg, scalpel, laser, cryoprobe, electrosurgery, photodynamic therapy). [36]

Patients should avoid any causal factor, such as use of tobacco and alcohol. Leukoplakias can regress under these circumstances. Any degree of dysplasia in a lesion at a high-risk site must be taken seriously and the lesion should be removed. Given that even evidently nondysplastic lesions may still contain malignancy in up to 10%, surgical removal of the lesion is advocated. Occasionally, patients are treated by photodynamic therapy or topical cytotoxic agents, but the evidence for efficacy is slender. Patients should be examined regularly, probably at 3- to 6-month intervals.

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Surgical Care

Management of leukoplakias is far from satisfactory, [37] and no large trials offer guidance as to the most reliable treatment. Surgical removal of leukoplakia seems one reasonable option. Some experts surgically remove these lesions with scalpel, laser, or cryoprobe. Laser excision is preferred to fulguration. [29, 38] Others point out the possible aggravation of dysplasia caused by such operative intervention and that surgical removal of aneuploidic lesions does not necessarily improve mortality rates. [39]

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