Over time two different lesions develop: Homogenous OL This is the most common form It is seen as a uniformly white plaque, prevalent in the buccal mucosa Lesions have a low malignant potential Non-homogenous OL Refers to irregularity of either the colour and / or the texture Lesions can be white or white-red (erythroleukoplakia) The irregular texture can be flat, nodular, exophytic or verrucous Lesions have a much greater malignant potential Certain criteria demonstrate a higher risk of malignant change: Non-homogenous OL, especially the verrucous type Long-standing and / or larger lesions Sites - lesions on the soft palate, anterior floor of the mouth and the ventrolateral tongue - sublingual OL has a particularly high risk of transformation Lesions NOT associated with tobacco smoke Female patients Candidal OL may have a higher risk Features which indicate that malignant transformation into an SCC has already occurred include: Bleeding, erosion and ulceration The presence of induration / a nodule Hairy leukoplakia Is caused by the EBV, and is found in immunocompromised patients It presents as a white, corrugated thickening, usually affecting both sides of the tongue It appears to be benign and self-limiting Other conditions causing white patches in the mouth include: Lichen planus , candidosis , cheek biting and materia alba Clinical Images Please refer to notes on image rights at bottom of the page with regards to individual image ownership
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