Format

Send to

Choose Destination
Oral Dis. 2018 Jul;24(5):749-760. doi: 10.1111/odi.12830. Epub 2018 May 2.

Proliferative leukoplakia: Proposed new clinical diagnostic criteria.

Author information

1
Division of Oral Medicine and Dentistry, Brigham and Women's Hospital and Dana Farber Cancer Institute, Boston, MA, USA.
2
Department of Oral Medicine Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
3
Department of Oral & Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, NY, USA.
4
Stomatology Department at AC Camargo Cancer Center, Sao Paulo, Brazil.
5
Department of Comprehensive Dentistry, School of Dentistry, UT Health San Antonio, San Antonio, TX, USA.

Abstract

OBJECTIVE:

We aimed to characterize proliferative verrucous leukoplakia (PVL) from a clinical and histopathological standpoint and suggest an updated classification.

SUBJECTS AND METHODS:

Records of patients seen at three oral medicine centers with a clinical diagnosis of PVL were reviewed for clinical and histopathological features and malignant transformation (MT).

RESULTS:

There were 42 patients (median age: 69 years [range: 36-88]; 35 females). 12.2% were current smokers. Family history of cancer was present in 43.7% of patients. Partial demarcation of lesion margins was present in 31.3% of lesions, followed by verrucous (27.5%), smooth (22.7%) erythematous (22.3%), and fissured (18.3%) appearance. Large and contiguous and multisite and non-contiguous lesions comprised 57.1% (24/42) and 35.7% (15/42) of PVL cases, respectively. 19.1% had prominent erythema (erythroleukoplakia). The most common histopathological diagnosis at first visit was hyperkeratosis without dysplasia (22/42; 56.4%). MT occurred in 71.4% patients after a median of 37 months [range: 1-210] from initial visit; erythroleukoplakia exhibited MT in 100% of cases.

CONCLUSION:

The generic term "proliferative leukoplakia (PL)" may be more appropriate than PVL because 18.3% were fissured and 22.7% erythematous. We also propose the term proliferative erythroleukoplakia to more accurately describe the subset of PL with prominent erythema, which had the highest MT rate.

KEYWORDS:

malignant transformation; proliferative; proliferative verrucous leukoplakia

PMID:
29337414
DOI:
10.1111/odi.12830
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center