Differential diagnosis of two white lesions in jugal mucosa: case report

Abstract

Leukoedema is a change that affects the jugal mucosa bilaterally, presenting as a whitish or grayish-white plaque. It has uncertain etiology, but is believed to be derived from a developmental change, while leukoplakia is a clinical term for the definition of a non-shaved white plaque that can affect the jugal mucosa and other oral sites. Its etiology may be linked to the use of tobacco, alcohol and ultraviolet radiation, being considered a potentially malignant lesion and treatment will depend on the degree of cellular dysplasia and extent of the lesion. The aim of this article is to present a clinical case of a patient diagnosed with two white lesions in the jugal mucosa. A 57-year-old female brown patient sought dental care complaining of white spots on her cheeks. She reported being a smoker for 35 years, having the habit of consuming a pack and a half a day. After clinical examination, the diagnostic hypotheses of leukoedema and leukoplakia were raised. Incisional biopsy, followed by histopathological analysis, confirmed the diagnosis of leukoedema with overlapping leukoplakia. Leukoedema does not require treatment as it is a variation of normality. However, it may be clinically associated with disorders that require intervention, as in the case presented, generating masking of characteristics and, consequently, diagnostic confusion.