REPORT OF A CASE
An 80-year-old man with a complaint of ill-fitting dentures was referred for evaluation of extensive oral leukoplakia (Fig 1). He related a 30-year history of this condition, which first appeared as a flat, filmy patch on the anterior edentulous mandibular ridge. The white areas slowly spread across the mandibular arch, from the ventral aspect of the tongue onto the buccal and labial mucosa and posteriorly to the tonsilar pillars. The lesions gradually became exophytic and verrucous (Fig 2).Evidence of ulceration or erythema associated with this asymptomatic condition was not present. The patient had sought the advice of numerous physicians and dentists over the years but was never given a diagnosis or received effective treatment. The patient never used tobacco and was in good health otherwise. Representative biopsy specimens are shown in Figs 3 and 4.What is your diagnosis?
Proliferative verrucous leukoplakia (PVL).
Hall JM, Cohen MA, Moreland AA. Multiple and Confluent Lesions of Oral LeukoplakiaProliferative Verrucous Leukoplakia. Arch Dermatol. 1991;127(6):887-888. doi:10.1001/archderm.1991.01680050131016