Leukoplakia is the clinical term used to describe a white patch on the mouth membranes which cannot be given another diagnostic name, i.e. it is a diagnosis of exclusion. Once a biopsy is performed the term may still be used but should be modified to included the presence or absence of atypical or dysplastic epithelial cells. Typically, the patient is older than 45 years of age and is male. There is a strong association with tobacco use and perhaps with alcohol abuse. The lesion is benign but about 4% go on to become cancers. Surgical or laser removal is the treatment, but there is a high rate of recurrence and so close follow-up is important.
Conservative surgical excision remains the treatment of choice for small leukoplakias. Electrocautery, cryosurgery and laser ablation appear to be equally effective, although thermal excision tends to hinder a pathologist’s ability to evaluate extension and degree of dysplasia. The key is long-term follow-up after removal, because recurrences are frequent and additional leukoplakias occur. Clinical evaluation every six months is recommended, every 2-3 months .Treatment sites remaining disease free for three years need no longer be followed, but any patient with residual leukoplakia should be followed for a lifetime.
