Idiopathic leukoplakia

Idiopathic leukoplakia is a white-greyish lesion (patch or plaque), which cannot be removed, being asymptomatic and devoid of pathology. It mainly concern males between 30 and 60 years of age. Typically, the leukoplakia is situated on the underside/margins of the tongue, the floor of the oral cavity but also on the buccal and masticatory mucosa; it can be a single, multi-focal or widespread. A homogeneous variant, whereby the lesion is smooth and slightly corrugated, can be distinguished from a non-homogeneous variant which has a wrinkled, warty or nodular appearance. Leukoplakia can occur with a red area (erytholeukoplakia), the latter which often indicates histo-pathological changes, tending to dysplasia. Each white lesion cannot be removed and, in the absence of persisting trauma, it should be subject to a biopsy and thereafter a histo-cytopathological investigation. Lesions not presenting dysplasia or low grade dysplasia should be monitored as part of clinical follow-up. Those presenting high grade, dysplastic changes must be removed and the site periodically checked (every 3-4 months). Patients must not only be followed up clinically but also receive counselling regarding self-evaluation, change their lifestyle (quit smoking and alcohol consumption), encouraged to improve their oral hygiene and consume a diet high in fruit and vegetables.