leukoplakic

Leukoplakic is an adjective used in medicine to describe a white patch or plaque on a mucous membrane that cannot be rubbed off and cannot be attributed to any other diagnosable condition. While commonly applied to lesions of the oral cavity, the term can also refer to similar white mucosal patches in other sites. Leukoplakic lesions are heterogeneous and range from benign-appearing keratoses to premalignant conditions.

Clinically, leukoplakic lesions are typically described as well-defined, flat or slightly raised white areas. They most often occur on the tongue, floor of the mouth, buccal mucosa, or other areas within the oral cavity, though they can appear elsewhere. The surface may be smooth, fissured, or corrugated. The appearance alone does not distinguish benign from premalignant or malignant lesions, which is why histopathology is essential.

Etiology and risk factors include tobacco use (smoking or smokeless), heavy alcohol consumption, chronic irritation (such as ill-fitting dentures or cheek biting), and nutritional deficiencies. Human papillomavirus has been investigated as a contributing factor in some cases, but its role is not definitively established. Age, sex, and geographic factors can influence prevalence.

Diagnosis requires biopsy in most cases, because leukoplakic patches may harbor epithelial dysplasia or carcinoma in situ. Differential diagnosis includes candidiasis, frictional keratosis, lichen planus, hairy leukoplakia, and other white mucosal lesions.

Management focuses on eliminating risk factors, regular clinical surveillance, and biopsy-guided treatment. High-grade dysplasia or invasive cancer necessitates prompt surgical management. Prognosis depends on histologic grade and lesion location, with closer follow-up advised for high-risk lesions.