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Potentially malignant disorders revisited—The lichenoid lesion/proliferative verrucous leukoplakia conundrum

Lookup NU author(s): Dr Michaela Goodson

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Abstract

© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Background: Clinically identifiable potentially malignant disorders (PMD) precede oral squamous cell carcinoma development. Oral lichenoid lesions (OLL) and proliferative verrucous leukoplakia (PVL) are specific precursor lesions believed to exhibit both treatment resistance and a high risk of malignant transformation (MT). Methods: A retrospective review of 590 PMD patients treated in Northern England by CO2 laser surgery between 1996 and 2014 was carried out. Lesions exhibiting lichenoid or proliferative verrucous features were identified from the patient database and their clinicopathological features and outcome post-treatment determined at the study census date of 31 December 2014. Results: One hundred and 98 patients were identified as follows: 118 OLL and 80 PVL, most frequently leukoplakia at ventrolateral tongue and floor of mouth sites, equally distributed between males and females. Most exhibited dysplasia on incision biopsy (72% OLL; 85% PVL) and were treated by laser excision rather than ablation (88.1% OLL; 86.25% PVL). OLL were more common in younger patients (OLL 57.1 year; PVL 62.25 years; P =.008) and more likely than PVL to present as erythroleukoplakia (OLL 15.3%; PVL 2.5%; P =.003). Whilst no significant difference was seen between OLL and PVL achieving disease-free status (69.5% and 65%, respectively; P =.55), this was less than the overall PMD cohort (74.2%). MT was identified in 2 OLL (1.7%) and 2 PVL (2.5%) during follow-up. Conclusion: One-third of PMD cases showed features of OLL or PVL, probably representing a disease presentation continuum. Post-treatment disease-free status was less common in OLL and PVL, although MT was infrequent.

Publication metadata

Author(s): Thomson PJ, Goodson ML, Smith DR

Publication type: Article

Publication status: Published

Journal: Journal of Oral Pathology and Medicine

Year: 2018

Volume: 47

Issue: 6

Pages: 557-565

Print publication date: 01/07/2018

Online publication date: 16/04/2018

Acceptance date: 08/04/2018

ISSN (print): 0904-2512

ISSN (electronic): 1600-0714

Publisher: Blackwell Publishing Ltd

URL: https://doi.org/10.1111/jop.12716

DOI: 10.1111/jop.12716

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