Current management strategies for verrucous hyperkeratosis and. Oral leukoplakia tsvetanov ts1 abstract oral leukoplakia is defined as a predominantly white lesion of the oral mucosa that cannot be characterized as any other definable lesion. Patients with this condition represent a unique clinically and pathologically progressive characteristic from conventional leukoplakia. With leukoplakia lookohplaykeyuh, thickened, white patches form on your gums, the insides of your cheeks. Leukoplakia, also called leukokeratosis or leukoplasia is a medical condition in which plaque, keratin and irregular patch formation occurs on the mucous membrane of the oral cavity, gastrointestinal tract or the linings of the urinary tract and the genitals. Proliferative verrucous leukoplakia of the gingiva how is. Verrucous carcinoma registered dental hygienist rdh. Proliferative verrucous leukoplakia is a rare form of ol which has multiple recurrences, is refractory to treatment and has malignant transformation in a short period. It is characterized by a high rate of oral squamous cell carcinoma and verrucou carcinoma transformations. After this study, these lesions were named oral proliferative verrucous leukoplakia opvl. Flat leukokeratosis under unfavorable conditions becomes verrucous and further neglect of treatment leads to erosive form. Proliferative verrucous leukoplakia pvl is a rare type of oral leukoplakia, where white patches that have a high risk of becoming cancerous develop inside the mouth.
Image exophytic leukoplakia on the buccal mucosa 11. The possible presence of several forms simultaneously on different areas of the oral cavity, each of which can at any time to regenerate into a malignant neoplasm. Proliferative verrucous leukoplakia has association with human papilloma virus infection. Pdf white lesions both physiologic as well as pathologic are relatively frequent in the oral cavity, the most common pathology being oral. Proliferative verrucous leukoplakia merupakan tipe leukoplakia yang agresif yang hampir selalu. Proliferative verrucous leukoplakia registered dental. The majority of conventional leukoplakia remains constant and only a subset progress to high. This is a noninvasive procedure, but does not always result in a. Oral diseases 2010 16, 328332 proliferative verrucous leukoplakia pvl is of uncertain etiology but may be associated with human.
Veruccoid keratotic plaques are formed in this case, that spread to adjoining areas. Hpv16 infection may play an important role in these lesions. Tell a friend about us, add a link to this page, or visit the webmasters page for free fun content. Pada verrucous leukoplakia, permukaan lesi tampak sudah menonjol, berwarna putih, tetapi tidak mengkilat. Pdf proliferative verrucous leukoplakia a recalcitrant. Proliferative verrucous leukoplakia genetic and rare.
This function is accomplished through a ligation between betacarotene and oxygen, which is an unstable reactive molecule, thus diminishing the damaging effects of free radicals lycopene in vitro experiments have shown the inhibition of the process of human neoplastic cellular growth by lycopene, since this. Carcinoma, proliferative verrucous leukoplakia and ebv med oral patol oral cir bucal. Proliferative verrucous oral leukoplakia is a subtype of verrucous leukoplakia according to some authors3,6. Oral leukoplakia describes a white patch or plaque of the oral mucosa that cannot be characterised clinically or pathologically as any other disease.
Proliferative verrucous leukoplakia and verrucous hyperplasia. The most effective methods of oral leukoplakia treatment. Proliferative verrucous leukoplakia of the gingiva, report of two cases with malignant transformation nadereh ghanee dmd, selene saraf, mary nathanson kilo md and kristina waggoner pacific northwest kaiser dental, usa case report open access journal of clinical and anatomic pathology. Proliferative verrucous leukoplakia of the gingiva, report. This may lead to dysplasia, that may eventually progress to verrucous carcinoma. Aug 18, 2019 verrucous leukoplakias are usually heavily keratinized and are often seen in elderly people. Leukoplakia definition leukoplakia is the most common premalignant or potentially malignant lesion of the oral mucosa. It has a number of possible causes, including repeated injury or irritation. Proliferative verrucous leukoplakia pvl is an aggressive form of oral leukoplakia that is persistent, often multifocal, and refractory to treatment with a high risk of recurrence and malignant transformation. Objectives to provide an overview of the current thinking in terms of the diagnosis and management of oral leukoplakia and proliferative verrucous leukoplakia as relevant to general dental. Jan 29, 20 proliferative verrucous leukoplakia is a rare form of ol which has multiple recurrences, is refractory to treatment and has malignant transformation in a short period. Since then, various published case series have presented pvl as a disease with aggressive biological behavior due to its high probability of recurrence and a high rate of malignant transformation, usually higher than 70%. It mainly involves the lining inside of the cheeks buccal mucosa and tongue.
Frequent alterations of p16 and p14 in oral proliferative verrucous. If you have leukoplakia, your doctor will likely test for early signs of cancer by. As mentioned above, most pvl cases processed to malignancy over many years, sometimes 20 years. Proliferative verrucous leukoplakia of the gingiva, report of two cases with malignant transformation nadereh ghanee dmd, selene saraf, mary nathanson kilo md and kristina waggoner. Oral leukoplakia, as traditionally defined by the world health organization who, is a predominantly white lesion of the oral mucosa that cannot be characterised as any other definable lesion. Oral proliferative verrucous leukoplakia opvl is a rare form of oral leukoplakia, which was first described in 1985 by hansen et al, it is characterized by a distinct clinical form and defined by its progressive clinical course, changing clinical and histopathological features, and potential to develop into cancer usually higher than 70%. It is a form of leukoplakia, which refers to white patches on the mucous membranes of the mouth often arising in response to chronic irritation.
Proliferative verrucous leukoplakia is a diffuse white andor papillary lesion seen in older patients, often associated with human papilloma viruses, which has an inexorably slow progression over one or two decades, to verrucous or squamous cell carcinoma candidal leukoplakias may be associated with an increased risk of malignant change ch. The diagnosis of this entity is predicated on a temporal constellation of clinical features and histopathologic findings. Verrucous carcinoma proliferative verrucous leukoplakia hyperkeratosis. Oral leukoplakia symptoms, diagnosis and treatment bmj. Among different forms of leukoplakia, proliferative verrucous leukoplakia has high malignant transformation. Oral leukoplakia ol is defined as a white plaque of questionable risk having excluded other known diseases or disorders that carry no increased risk for cancer. Leukoplakia causes, pictures, symptoms, treatment, prognosis. Proliferative verrucous leukoplakia is a multifocal and progressive lesion of.
Proliferative verrucous leukoplakia and its related lesions. Data sources, data selection, data extraction, data synthesis we searched the medline ovid, embase databases and the cochrane library, 1990 to 16 april 2017, restricting our search to english. Abstract the main purpose of this paper was to assess the current state of science on oral leukoplakia. Get 50% off quizlet plus through monday learn more. Carcinoma, proliferative verrucous leukoplakia and ebv epsteinbarr virus in oral proliferative verrucous leukoplakia and squamous cell carcinoma. The lesions were closely monitored for any changes suspicious for invasive squamous cell carcinoma or verrucous carcinoma. Proliferative verrucous leukoplakia pvl is a rare form of oral leukoplakia, with high recurrent rates and a high risk of malignant. However, leukoplakia is not limited as an oral disorder alone, as it may also appear in the genital area of the female. Histopathologically, proliferative verrucous leukoplakia pvl changes gradually. Leukoplakia is a condition wherein white or gray patches appear in some parts of the mouth, predominantly in the buccal mucosa and the tongue. Proliferative verrucous leukoplakia of the gingiva, report of. Proliferative verrucous leukoplakia is a disease of the oral cavity in which verrucous hyperplasia is a part of its developmental spectrum. Proliferative verrucous leukoplakia of the gingiva how.
Proliferative verrucous leukoplakia pvl is a rare form of oral. The term leukoplakia is a clinical descriptor only and should not be used once. Expression of p53 and loss of expression of p16 are shown to be the earliest events in the malignisation process. It is a type of nonhomogeneous leukoplakia that affects the gum and the buccal mucosa. Oral leukoplakia may later prove to be due to one of the following conditions. May 19, 2017 the surface texture is irregular compared to homogenous leukoplakia, and may be flat papular, nodular or exophytic. Oral leukoplakia and proliferative verrucous leukoplakia. The surface texture is irregular compared to homogenous leukoplakia, and may be flat papular, nodular or exophytic. Although the diagnosis was not proliferative verrucous leukoplakia pvl at this time, early stages of the disease have a very similar clinical appearance, and pvl is known to progress through stages from hyperkeratosis to dysplasia followed by squamous cell carcinoma. Since then, various published case series have presented pvl as a. Proliferative verrucous leukoplakia is a rare and distinct variant of oral leukoplakia.
A rare, recalcitrant, and lethal form of leukoplakia necessitate special attention. This figure is higher for the nonhomogeneous form, especially the proliferative verrucous variant, which nearly always becomes cancerous. Proliferative verrucous leukoplakia pvl is a rare oral leukoplakia and has four features such as chronic proliferation, multiple occurrences, refractoriness to treatment and high rate of malignant transformation. It can also be a sign of precancerous changes in the mouth or mouth cancer. It is defined as essentially an oral mucosal white lesion that cannot be considered as any other definable lesion. Case report of rapidly progressive proliferative verrucous. Figure 3 proliferative verrucous leukoplakia on the. Scitech verrucous leukoplakia a diagnostic dilemma. Proliferative verrucous leukoplakia pvl represents a rare but highly. Proliferative verrucous leukoplakia is a multifocal and progressive lesion of the oral mucosa, with unknown etiology, and commonly resistant to all therapy attempts with frequent recurrences. It starts as a white plaque of thickened skin hyperkeratosis that eventually spreads and forms rough, wartlike verrucous lesions that may look. Objectives to provide an overview of the current thinking in terms of the diagnosis and management of oral leukoplakia and proliferative verrucous leukoplakia as relevant to general dental practitioners.
Proliferative verrucous leukoplakia pvl is a rare form of oral leukoplakia with a malignant transformation rate of 70%. Proliferative verrucous leukoplakia proliferative verrucous leukoplakia pvl is a recognized high risk subtype of nonhomogenous leukoplakia. It is characterized by the appearance in the oral cavity of white plaques in multiple locations and with different forms of presentation homogeneous, patchy, verrucous that progress. Oral leukoplakia is a potentially malignant disorder affecting the oral mucosa. Kanmani2, n megalai3 1department of oral medicine and radiology, indira gandhi institute of dental sciences, pondicherry, india, 2department of oral medicine and radiology, srm.
Proliferative verrucous leukoplakia of the gingiva. Retinoids and proliferative verrucous leukoplakia pvl. Among them oral leukoplakia ol is quite prevalent 0. This article describes the clinical aspects and histologic features of a case that demonstrated the typical behavior pattern in a longstanding, persistent lesion of pvl of the. How is proliferative verrucous leukoplakia differentiated. Nov 06, 2017 proliferative verrucous leukoplakia pvl is a rare type of oral leukoplakia, where white patches that have a high risk of becoming cancerous develop inside the mouth. Because of the lack of defined pathologic lesions, identifying patients with the early diagnosis of pvl is challenging. Proliferative verrucous leukoplakia exhibited histopathologic features along a progressive spectrum, evolving from leukoplakia to verrucous hyperplasia and ultimately invasive carcinoma. Separately, you can observe leukokeratosis in smokers. Retinoids and proliferative verrucous leukoplakia introduction proliferative verrucous leukoplakia pvl was first described by hansen et al. Carcinoma in situ of the oral cavity intraepithelial carcinoma nicotine stomatitis. Proliferative verrucous leukoplakia is a rare form of ol which has multiple recurrences, is refractory to treatment and has malignant transformation in a short. Each has been shown to have a considerable propensity to progress to carcinomaeither verrucous or conventional squamous cell carcinoma of varying degrees of differentiation.
However, this report described a case of rapid progress, which had malignant. Optimal management of proliferative verrucous leukoplakia. Malignant transformation of proliferative verrucous leukoplakia to. Leukoplakia is a predominantly white lesion of the oral mucosa than cannot be clinicopathologically characterized as any other definable lesion. Abstract introduction proliferative verrucous leukoplakia is an uncommon but distinctive, precursor lesion of squamous cell carcinoma. It can be characterized as a solitary, recurring, progressive white patch that develops a verruciform architecture and may not be associated with hpv. The management of oral leukoplakia varies from a wait and see attitude and topical chemopreventive agents to complete surgical removal. Verrucous carcinoma registered dental hygienist rdh magazine.
Soames and southam reported mutations of p53 in the cells from dysplastic areas of some leukoplakias who smoke and drink heavily. Proliferative verrucous leukoplakia pvl is rare high risk form of leukoplakia first described by hansen and. This involves removing cells from the surface of the lesion with a small, spinning brush. A less recognized form known as proliferative verrucous leukoplakia pvl represents a unique progressive and elusive variant. Leukoplakia could be classified as mucosal disease, and also as a premalignant condition. Leukoplakia appears as thick, white patches on the inside surfaces of your mouth. Proliferative verrucous leukoplakia pvl is an uncommon form of progressive multifocal leukoplakia with a high rate of malignant transformation to either squamous cell cancer or verrucous carcinoma and a high probability of recurrence. Leukoplakia bervariasi dalam ukuran, bentuk dan gambran klinis. Enormous effort has been dedicated to this cancer, and the past decades have witnessed significant advances in relevant diagnostic and therapeutic. A retrospective analysis for clinicopathologic features wanjari g sonalika, tegginamani anand department of oral and maxillofacial pathology, hitkarini dental college and hospital, jabalpur, madhya pradesh, india.
Proliferative verrucous leukoplakia of the gingiva pvlg appears to be a subset of oral proliferative verrucous leukoplakia. Tipe leukoplakia ini biasanya disertai dengan keluhan ringan berupa ketidaknyamanan atau nyeri yang terlokalisir. Feb 20, 2019 proliferative verrucous leukoplakia pvl is an uncommon form of progressive multifocal leukoplakia with a high rate of malignant transformation to either squamous cell cancer or verrucous carcinoma and a high probability of recurrence. Proliferative verrucous leukoplakia pvl is a rare less recognized form of oral leukoplakia.
Pdf on apr 3, 2017, mervet moussa and others published oral proliferative verrucous leukoplakia. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Proliferative verrucous leukoplakia can have a papillary and roughened surface, which may simulate the corrugated surface of oral hairy leukoplakia. Oral verrucous carcinoma ovc is a verrucous variant of oral squamous cell carcinoma oscc, which accounts for 212% of all oral carcinomas with a 5year survival rate of only approximately 50%. Proliferative verrucous leukoplakia of the gingiva listed as pvlg. Proliferative verrucous leukoplakia pvl is a rare form of oral leukoplakia, which was first described in 1985 by hansen et al. It involves multiple mucosal areas with confuent, exophytic and proliferative features. Proliferative verrucous leukoplakia pvl and verrucous hyperplasia vh are two interrelated oral mucosal lesions. Although the white color in leukoplakia is a result of hyperkeratosis or acanthosis, similarly appearing white lesions that are caused by reactive keratosis smokers keratosis or frictional keratoses e. A large proportion of oral cancers are associated with preceding longstanding oral leukoplakia and possibly 1% of oral leukoplakias overall become cancer. In a study of 54 cases of proliferative verrucous leukoplakia, silverman and. Human papillomavirus, as a cefaclor, plays a role in some of the lesions.