ORAL LEUKOPLAKIA

Leukoplakia has evolved as a clinico-pathologic concept over many year s, with the current clinical designation being accepted worldwide. Ref lective of the biology of leukoplakia is the concept of cellular atypi a and epithelial dysplasia. Adding to a better understanding of leukop lakia in general has been the definition of relevant clinical subsets which, in some cases, includes etiology (snuff), while in other cases a verrucous clinical appearance will suggest a more aggressive anticip ated behavior pattern. Tobacco usage, in many of its forms, remains th e prime etiologic factor; however, other considerations also apply. Mo re recently, the potential etiologic role of Candida albicans has been stressed, as well as its possible role in carcinogenesis. So-called o ral hairy leukoplakia has been defined in relation to a possible Epste in-Barr viral infection, usually in the immunosuppressed patient. Othe r viruses, human papilloma virus in particular, have been implicated i n leukoplakia, while genetic alterations involving tumor suppressor el ements (p53) have also been investigated. Finally the management of th is common condition remains a variable and includes local, topical, an d systemic therapies such as anti-oxidants, carotenoids, and retinoids .