Leukoplakia is a Greek term that means white plaque. It presents as a white patch on the epithelium indicating keratin that cannot be scraped easily. It is a nonspecific clinical term and represents a wide variety of lesions without taking into account any etiological and histopathological features. It is usually a result of chronic inflammation or exposure to irritants and may histologically represent varying degrees of epithelial dysplasia ranging from keratotic hyperplasia to microinvasive cancer. Leukplakia may be present in the mouth, throat or on the vocal folds. Leukoplakia may cause symptoms such as hoarseness, or may be found incidentally during an examination.
Direct laryngoscopy with biopsy is advised in almost all cases. Histologic examination usually demonstrates mild, moderate, or severe dysplasia. In some cases, invasive squamous cell carcinoma is present in the initial biopsy specimen. Cessation of smoking may reverse or stabilize mild or moderate dysplasia. Some patients—estimated to be less than 5% of those with mild dysplasia and about 35–60% of those with severe dysplasia—will subsequently develop squamous cell carcinoma.
- Cigarette smoking and alcohol
- Gastroesophageal reflux
- Human papilloma virus infection
Treatment options include proton-pump inhibitor therapy, close follow-up with laryngovideostroboscopy, serial resection, and external beam radiation therapy