Oral leukoplakia – What are the signs and symptoms, relevant dDx., sequelae, work up, and treatment options?

Oral leukoplakia (hairy tongue) is hyperkeratosis of the oropharynx, and can be benign (white patches) or cancerous (red, speckles, ulcers). It is most commonly seen on the floor of the mouth, soft palate, and ventral/lateral surfaces of the tongue), strongly associated with tobacco use and alcohol consumption, HIV, EBV, immunocompromised states and oral cancer (squamous cell carcinoma).

Sn. & Sx.:

• Swollen tongue
• Fixed white plaques on the tongue
• Homogenous or speckled white plaques with sharply demarcated borders
• Ulcers on the floor of the soft palate, buccal mucosa or tongue
• “Hairy” appearance

dDx.:

• Candidiasis
• Lichen planus
• Oral cancer, squamous cell carcinoma

Sequelae:

• Oral squamous cell carcinoma

Work up:

• Clinical biopsy

Tx.:

• Excision or ablation
• Cryotherapy

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This post was written by Omar Rifai