It is a hyperkeratotic disease White oral precancerous lesion Have risk for malignant Most commonly in buccal mucosa, vermillion border of lower lips & gingiva. But, less common of palate, maxillary mucosa, retromolar area, tongue & floor of mouth & tongue (more high risk) More frequently found in male

IT IS EITHER : Homogenous/ thick leukoplakia: white patches ,corrugated ,with fine lines + wrinkled or papillomatous. Nodular: "most serious" it is composed of : White areas: hyperkeratotic white nodules. Red areas: an atrophic erythematous background Virrocus: hyper keratinized white surface &multiple papillary projections that are heavily keratinized.

ETIOLOGY: predisposing factors: oSYSTEMIC: Vit B & folic acid deficiency. Xerostomia. Tertiary syphilis. Anti cholinergic medications. Plummer Vinson syndrome. oLOCAL: Tobacco: main etiologic factor. Alcohol (promoter that exhibits a strong synergistic effect) Candidiasis. Mechanical& chemical irritations Herpes simplex electrogalvanic reactions Sunlight (specifically, ultraviolet radiation)

By: History, location, &shape but pathologically it is only hyperkeratosis.

Sign and syptomsVaried from a small to large area of hyper keratosis. Usually painless ,unless become eroded or fissured. Loss of flexibility. Lack of papilla on tongue at site of lesion.

Important clinical criteria include location, appearance, known irritants, and clinical course. For the persistent lesion, however, the definitive diagnosis is established by tissue biopsy. Total excision is aggressively recommended when microscopic dysplasia is identified. COULD BE PREMALIGNANT changes.

If a leukoplakia lesion disappears spontaneously or through the elimination of an irritant, no further testing is indicated.

Local cause must be removed (e.g. Tobacco, Alcohol), if no dysplasia is foundconservative it will be acceptable. In case of dysplasia: surgical excision with or without grafting. Cryosurgery, laser performed for rapid healing. After surgical removal, long-term monitoring of the lesion site is important since recurrences are frequent and because additional leukoplakias may develop