Intraoral ‘leukoplakia’

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LEUKOPLAKIA has become a convenient catchall term for many epithelial abnormalities within the mouth. According to Sprague1 the term was first used by Schwimmer in 1887; it simply means “white patch.” White patches are common in the mouth. Oral epithelium is constantly moist, and those abnormalities or portions of oral epithelium which are characterized by excess keratin will take on a white appearance because keratin characteristically turns white when it is thoroughly wet. As occurs with squamous epithelial surfaces elsewhere in the body, so too in healthy oral mucosa there is an orderly progression of epithelial cells toward the surface, and a continuing desquamation takes place without keratin accumulation.

If a painless, unobtrusive, or even unnoticed, white patch in the mouth had no more significance than a callus on a laborer’s hands, then there would be no problem to discuss. There is real danger, though, in intraoral leukoplakia, since leukoplakia may be a premalignant condition or mask a lesion that is actually a carcinoma.

What Is Intraoral Leukoplakia?

Leukoplakia is a term to be used strictly for a clinical diagnosis of a white mucosal patch. It has no precise histopathologic meaning; as a definitive diagnosis (after biopsy) it should be abandoned; and it should not be used to designate carcinoma.2 Leukoplakia has been used to designate epithelial lesions in the mouth which are not white,3 and this has caused confusion. Lesions that are red and eroded in appearance should not be labeled leukoplakias.

Without keratin, intraoral epithelial lesions are not. . .



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