Spectrum of white lesions in the oral cavity- A review

The white lesions occurring in the oral cavity consist of 5% of the oral pathoses but some of these like leukoplakia, lichen planus, proliferative verrucous leukoplakia, etc have a high potential of malignant transformation up to 0.5-100%. As they are visualized as shades of white, they are of diagnostic challenge. Some of the lesions are also associated with other skin lesions viz. lichen planus, pemphigus, etc. The etiology, pathogenesis, and mode of treatment varies with the different type of lesions. This spectrum consists of lesions from harmless reactive lesions to dysplastic and malignant entities. The white appearance of these lesions is may be because of hyperkeratosis, acanthosis, intracellular/intercellular edema, necrosis of the epithelial cell or increased fibrosis. They are seen as patches, papules, or plaques unilaterally or bilaterally in the oral cavity involving buccal mucosa, tongue, palate, labial mucosa, gingiva etc. While there are a few clinical and histological elements that assist in the identification of this wide range of white lesions to arrive at an accurate diagnosis, further lending a hand in providing appropriate treatment for the same.