Oral leukoplakia is a white patch in the mouth that cannot be wiped off and has no other clear cause. It can turn into cancer, so it must be biopsied and watched over time.
Key symptoms
- White patch in the mouth, often painless
- Rough or thickened area felt with the tongue
- Red speckles or soreness in higher-risk patches
- History of smoking, chewing tobacco or heavy alcohol use
What you find on exam
- White plaque that does not scrape off, unlike thrush
- Note size, site and texture; the floor of the mouth and sides of the tongue are high risk
- Red areas, ulcers or hardness raise concern for cancer
- Feel the neck for lymph nodes
Tests
- Biopsy to look for dysplasia or cancer
- Repeat biopsy if the patch changes
- Photos to compare at follow-up
Treatment basics
- Stop all tobacco and alcohol
- Surgical or laser removal for dysplasia
- Regular follow-up exams, often every 3 to 6 months
- Fix sources of rubbing such as sharp teeth or poorly fitting dentures
Red flags
- Red patch, ulcer or bleeding within the white area
- Hard, fixed lesion or a neck lump
- Pain, numbness or trouble swallowing
Practice it in Making Synapses
Making Synapses cases
Related guides
Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations. Written by Making Synapses. Making Synapses is not affiliated with these organizations.