Leukoplakia

• Definition: hyperkeratosis of the epithelium and mucous membranes
• Persistent white plaques that cannot be scraped off
  • vs oral thrush
• Associated with alcohol and tobacco use
• Leukoplakia is considered a precancerous lesion since it carries an increased risk of malignant transformation. Needs to biopsy and remove.

Oral cavity cancer

• Halitosis
• Pain (e.g., earache)
  • Pain in oral cavity cancer is usually due to infiltration/compression of nerves
• Dysphagia
• Nonhealing ulcer
• Unusual bleeding in the mouth
• Lymphadenopathy

Oral lichen planus

• Thin, gray-white lines that form a reticular pattern (Wickham striae)
• Painful, atrophic, and erosive lesions may be present.
• Associated with dental materials, drugs (e.g., NSAIDs, ACE inhibitors), infection, autoimmunity (e.g., PBC), and IBD

Oral hairy leukoplakia

• Benign, painless, irregularly shaped white plaques with feathery or hairy appearance
• Most commonly located on the lateral tongue, but can also occur on the floor of the mouth, palate, or buccal mucosa
• Patches cannot be scraped off (in contrast to oral thrush)
• Etiology
  • EBV
  • Immunosuppression (e.g., patients with a history of organ transplantation)
  • Immunocompromise (e.g., HIV-positive individuals)