Leukoplakia is defined as a white, nonwipeable patch of the mucosa that cannot be assigned to any other disease. Synopsis of the classification of oral precursor lesions.
WHO 2005:Dysplasia | Ljubljana classification squamous intraepithelial lesions (SIL). | Squamous intraepithelial neoplasia (SIN). | Squamous intraepithelial neoplasia (SIN) reduced |
SquamousHyperplasia | Squamous (simple)hyperplasia | – – | – – |
MinorDysplasia | Basal and parabasal hyperplasia | SIN I | SIN: low risk |
Moderate grade dysplasia | Atypical hyperplasia(risk epithelium) | SIN II | SIN: high risk |
High grade dysplasia | SIN III | SIN: high risk | |
Carcinoma in situ | Carcinoma in situ | SIN III | SIN: high risk |
Invasive carcinoma |
White mucosal changes:
Clinic | Localization/age/sex | Diagnosis | Etiology |
Whitish, not wipeable, Wickham striae;extraoral (“outside the mouth”): reddish papules (“nodules”) |
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unexplained |
White, strippable, velvety coatings;mucosa underneath reddened, slightly bleeding |
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Candida albicanswith reduced general condition:antibiosis,diabetes, immunodeficiencies. |
Whitish, lentil-sized, possibly striate keratinization;extraoral: keratinizing papules |
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Rare keratinization anomalywith irregular inheritance. |
Erythema (skin redness) disc-shaped raised with central dent, white radial streaks, small ulcers (ulcers), possibly healing in white scars |
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autoimmune |
White stain, not wipeable, barely raised |
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Hyperkeratosis due to stress -z. E.g. sharp edges |
Field pavement cobblestone,whitish with central red dots |
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Tobacco condensates |
Whitish, cannot be wiped away, “hair-like “rippled or wrinkled, longitudinally striped, blurred borders |
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Epstein-Barr virus in AIDS |
Spot or area, white, flat, slightly raised, cannot be wiped away, sharply defined,surface smooth and homogeneous |
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idiopathic | |
Spot or area, white, mottled or spotted, cannot be wiped away, rough surface, nodular or warty elevations |
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Cofactors:tobacco,alcohol,syphilis,vitamin deficiency,chronic candidiasis. |
Spot or area white,mottled or spotted,cannot be wiped away,rough surface,blurred borders,reddish erosive lesions |
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MechanicalIrritation |