Treatment algorithm

Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups: see disclaimer

ACUTE

all patients

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removal of contributory factors

For all patients with oral leukoplakia, elimination of contributory factors is recommended (smoking cessation, elimination of areca nut (betel quid) use, and reduction of/abstinence from alcohol use). Follow-up is mandatory.

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observation with biopsy as needed

Treatment recommended for ALL patients in selected patient group

Where a representative biopsy shows benign disease and absence of epithelial dysplasia, frequent routine observation is an acceptable strategy. Repeat incisional biopsy of any clinical change is necessary, with excision of any confirmed dysplasia.

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excision

Treatment recommended for ALL patients in selected patient group

Surgical excision with or without autologous graft coverage is preferred. Alternatives include laser excision.

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excision

Treatment recommended for ALL patients in selected patient group

The high risk of significant dysplasia and malignant transformation of these forms of leukoplakia requires total excision, with or without autologous graft coverage.[147] Alternative treatment strategies to scalpel excisional surgery involve the use of laser excision.

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observation ± surgery

Treatment recommended for ALL patients in selected patient group

Due to extensive areas involved in proliferative verrucous leukoplakia (PVL) and its multifocal nature, it is difficult to eliminate by surgery without compromising function. PVL lesions often recur following surgery. PVL requires careful follow-up and scalpel excision if malignancy is suspected.

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Choose a patient group to see our recommendations

Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups. See disclaimer

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