ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferencesView all Images (21)
Leukoplakia - Oral Mucosal Lesion
See also in: Overview
Print
Other Resources UpToDate PubMed

Leukoplakia - Oral Mucosal Lesion

See also in: Overview
Print Images (21)
Contributors: Carl Allen DDS, MSD, Sook-Bin Woo MS, DMD, MMSc
Other Resources UpToDate PubMed

Synopsis

Leukoplakia is a clinical term only and refers to a mucosal white plaque that does not represent any other known clinical or histopathologic entity; it is therefore a clinical diagnosis of exclusion. Frictional keratoses have a specific etiology and are therefore not considered to be leukoplakias. Leukoplakia is a common oral finding that can be a precursor of mucosal squamous cell carcinoma. It is more common in smokers, but that may be because white plaques in smokers tend to be biopsied more frequently. The risk factors for this condition are the same as those for squamous cell carcinoma, and malignant transformation to invasive carcinoma occurs in 6% to 18% of patients.

All leukoplakias represent one of the following:
  1. Epithelial dysplasia, carcinoma in situ, or invasive carcinoma
  2. Hyperkeratosis of unknown etiology
In the older literature, the prevalence of dysplasia, carcinoma in situ, or invasive carcinoma (usually squamous cell carcinoma) was 10% to 20%. However, more recent data suggest that this may be as high as 40%.

Codes

ICD10CM:
K13.21 – Leukoplakia of oral mucosa, including tongue

SNOMEDCT:
274134003 – Leukoplakia

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

  • Frictional keratoses, specifically morsicatio mucosae oris and benign alveolar ridge keratosis, are located on nonkeratinized areas that are readily traumatized and on the alveolar ridge, respectively, and have specific histopathologic findings.
  • Oral hairy leukoplakia is most frequently seen in HIV and AIDS patients, and Epstein Barr virus is present in the biopsy.
  • Lichen planus is usually bilateral, symmetric, and reticulated.
  • Candidiasis resolves with anti-fungal therapy.
  • Smokeless tobacco keratosis occurs where the tobacco is placed.
  • Nicotinic stomatitis occurs on the palate almost exclusively and is symmetric with red punctate areas.
  • Squamous cell carcinoma
  • Dyskeratosis congenita (these are true leukoplakias that develop in patients with this disease)
  • Leukoedema is diffuse, gray-white, and disappears on stretching.
  • White sponge nevus is an extremely rare oral condition with specific histopathologic findings.

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

References

Subscription Required

Last Updated: 03/11/2015
Copyright © 2019 VisualDx®. All rights reserved.
Leukoplakia - Oral Mucosal Lesion
See also in: Overview
Print 21 Images Filter Images
View all Images (21)
(with subscription)
 Reset
Leukoplakia : Oral white plaque
Clinical image of Leukoplakia
Copyright © 2019 VisualDx®. All rights reserved.