|DENTAL SCIENCE - REVIEW ARTICLE
|Year : 2015 | Volume
| Issue : 5 | Page : 165-166
Leukoplakia: A short review on malignant potential
K. M. K. Masthan, N Aravindha Babu, S Leena Sankari, C Priyadharsini
Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
|Date of Submission||31-Oct-2014|
|Date of Decision||31-Oct-2014|
|Date of Acceptance||09-Nov-2014|
|Date of Web Publication||30-Apr-2015|
Dr. C Priyadharsini
Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Oral leukoplakia is one of the most common potentially malignant disorders. Right diagnosis of potentially malignant disorders may help to prevent these lesions from malignant transformation. Proper understanding, recognizing, identification and differentiating these lesions from normal mucosa are necessary for proper treatment.
Keywords: Leukoplakia, malignant potential, types
|How to cite this article:|
Masthan K, Babu N A, Sankari S L, Priyadharsini C. Leukoplakia: A short review on malignant potential. J Pharm Bioall Sci 2015;7, Suppl S1:165-6
The word leukoplakia means white patch (leuko-white, plakia-patch). It is considered as the premalignant lesions, but now included in a broader term for common usage of tobacco in the form of smoking and chewing. High-risk of malignant transformation is encountered if the risk factors are not eliminated. It has been reported that many oral squamous cell carcinoma develops from the potentially malignant disorders. Correct diagnosis and the right treatment at right time of potentially malignant disorders may prevent malignant transformation of these lesions.
The term "potentially malignant disorders" was defined by World Health Organization (WHO) as the risk of malignancy being present in a lesion or condition either during the time of initial diagnosis or at a future date.  WHO defined leukoplakia as "a white plaque of questionable risk having excluded (other) known diseases or disorders that carry no increased risk for cancer." ,
| Classification|| |
Clinically it is classified into four types:
- Early or thin
- Homogenous or thick
- Granular or verruciform and
- Speckled or erythroleukoplakia.
Each subdivision has a different malignant transformation potential. 
| Malignant Potential|| |
Leukoplakia is considered has the most common premalignant lesion. According to the systematic review, the estimated prevalence rate of leukoplakia is 2% worldwide.  Those lesions present particularly in the floor of the mouth, tongue, lip and vermilion have a high risk of malignant potential.
| Types of Leukoplakia and Their Malignant Potentia|| |
Thin leukoplakia frequently becomes malignant without any clinical changes. 
| Other Forms of Leukoplakia|| |
Proliferative verrucous leukoplakia
It is the most aggressive form of leukoplakia and was first described by Hansen et al. in 1985. It is multifocal parch often presents with surface projections. The lesion usually tends to spread slowly. Most commonly seen in gingival but other site are also affected.  Bagan et al.  and Batsakis et al.  have reported that squamous cell carcinoma development in 63.3% and 100% of proliferative verrucous leukoplakia respectively. Usually, the transformation occurs within 8 years of initially diagnosis of proliferative verrucous leukoplakia. 
Candidal leukoplakia (CL) is a chronic form of candidiasis. It is generally characterized by firm, white, leathery plaques. The lesion is commonly seen on the cheeks, lips, palate, and tongue. Epithelial dysplasia commonly occurs 4-5 times more frequently in CL when compared with other forms of leukoplakia. 
| Five Clinical Criteria Demonstrate a Particularly High Risk of Malignant Change|| |
- The high risk is considered to be the verrucous type
- If the lesion is associated with erosion or ulceration then, the lesion is suggested to have high malignant potential
- The presence of a nodule in the lesion indicates higher malignant potential
- A lesion that is hard and indurative in its periphery is predictive of malignant change
- Oral leukoplakia seen in the anterior floor of the mouth and undersurface of the tongue is strongly linked to malignant potential. 
| Conclusion|| |
Most cancers can be prevented if diagnosed at early stages. It is well known fact that most cancers arise from the potentially malignant disorders. Potentially malignant disorders are often overlooked due to inadequate knowledge. Proper understanding, recognizing, identification and differentiating these lesions and thorough knowledge about the malignant potential of these lesions will ensure proper treatment and pay a key role in saving patient life.
| References|| |
Amagasa T, Yamashiro M, Uzawa N. Oral premalignant lesions: from a clinical perspective. Int J Clin Oncol 2011;16:5-14.
Antony G, Sreenivasan BS, Sunil S, Varghese SS, Thomas J, Gopakumar D, et al. Potentially malignant disorders of oral cavity. Oral Maxillofac Pathol J 2011;2:95-100.
Neville BW, Damm DD, Allen CR, Bouquot JE. Oral and Maxillofacial Pathology. 2 nd
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Petti S. Pooled estimate of world leukoplakia prevalence: A systematic review. Oral Oncol 2003;39:770-80.
Mortazavi H, Baharvand M, Mehdipour M. Oral potentially malignant disorders: An overview of more than 20 entities. J Dent Res Dent Clin Dent Prospects 2014;8:6-14.
Bagan JV, Jimenez Y, Sanchis JM, Poveda R, Milian MA, Murillo J, et al. Proliferative verrucous leukoplakia: High incidence of gingival squamous cell carcinoma. J Oral Pathol Med 2003;32:379-82.
Batsakis JG, Suarez P, el-Naggar AK. Proliferative verrucous leukoplakia and its related lesions. Oral Oncol 1999;35:354-9.
Greenberg MS, Glick MG. Burket′s Oral Medicine: Diagnosis and Treatment. 10 th
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