Case history
Case history
A white-colored, smooth, and even area within the left mandibular mucolabial sulcus, of uncertain duration, is noted by a dental practitioner in a 64-year-old woman who denies smoking and alcohol consumption. The surrounding mucosa is clinically normal. The intraoral and head and neck examination is otherwise unremarkable.
Other presentations
Most oral leukoplakias are noted as white plaques in middle-aged and older populations that vary in thickness and surface features. The majority are found along the lateral tongue margin, the floor of the mouth, and as buccal/labial mucosa. The mucosal appearance will vary from a thin and homogeneous alteration to a thickened, white, leathery plaque. In some cases the mucosa may be fissured with the presence of red, or erythematous, areas irregularly scattered within the keratotic or white component (so-called "speckled leukoplakia"). White plaques seen within the retromolar region could be frictional (termed alveolar ridge keratosis), which have a much lower or negligible risk of malignant transformation than leukoplakias seen in other regions. Leukoplakia involving the dorsum of the tongue is uncommon. Some leukoplakias with "lichenoid" alterations may, in the absence of a confirmatory biopsy, be considered by some clinicians to be oral lichen planus and clinically benign. However, such lesions may have a significant dysplastic or malignant component, and should be closely monitored or biopsied if any change in appearance is noted.
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