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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 8  |  Issue : 1  |  Page : 33-35

Leukoplakia: A descriptive study


Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India

Date of Submission11-Nov-2021
Date of Decision09-Dec-2021
Date of Acceptance13-Jan-2022
Date of Web Publication12-Feb-2022

Correspondence Address:
Nidhi Thakur
Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jigims.jigims_46_21

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  Abstract 


Aim: Leukoplakia is a common premalignant lesion associated with the use of tobacco. This study was carried out to determine the prevalence of leukoplakia in a defined population.
Materials and Methods: In this study, 300 patients were included who reported to the outpatient dental department of Anugrah Narayan Magadh Medical College and hospital. The age, sex, and prevalence of leukoplakia were assessed in these patients.
Results: The study revealed a prevalence of 2% in the defined group of populations.
Conclusion: A high prevalence of leukoplakia needs a closer follow-up of these patients and a generalized screening for all the patients reporting to the dental department is required to reduce the number of premalignant conditions and lesions turning into malignancy.

Keywords: Leukoplakia, premalignant lesion, prevalence


How to cite this article:
Thakur N. Leukoplakia: A descriptive study. J Indira Gandhi Inst Med Sci 2022;8:33-5

How to cite this URL:
Thakur N. Leukoplakia: A descriptive study. J Indira Gandhi Inst Med Sci [serial online] 2022 [cited 2022 Jul 3];8:33-5. Available from: http://www.jigims.co.in/text.asp?2022/8/1/33/338365




  Introduction Top


Oral leukoplakia (OL) is a predominantly white lesion of the oral mucosa that cannot be characterized as any other definable lesion.[1] This is a clinical term that can be used only if other white lesions have been ruled out. The epidemiological data associated with OL are variable. The prevalence in the general population varies from <1 to more than 5%.[2],[3],[4],[5],[6] The rate of malignant transformation varies from almost 0% to about 20% in 1–30 years.[7],[8],[9] It was first mentioned in literature in 1969.[10] Tobacco use has been identified as the most important etiological agent for leukoplakia.[11] The use of alcohol is also an important etiological factor.[1] OL is classified into two main types: homogeneous type which appears as a flat white lesion and nonhomogeneous type which includes speckled, nodular, and verrucous leukoplakia.[11] The homogeneous leukoplakia is a uniform, thin white area altering, or not with normal mucosa. The speckled type is a white and red lesion with a predominantly white surface.[11] Verrucous leukoplakia has an elevated, proliferative, or corrugated surface appearance. The nodular type has small polypoid outgrowths, rounded predominantly white excrescences.[11]


  Materials and Methods Top


The present study was carried out to estimate the prevalence of leukoplakia in the population. Ethical clearance was obtained by the institutional review board and informed consent was obtained from all the patients. A simple random sampling was done in the patients reporting to the department of oral medicine and radiology for a period of 4 months. All the relevant data pertaining to the use of habit and its frequency, type, and duration were obtained. The criteria to diagnose leukoplakia were clinical assessment of the lesion. Since leukoplakia is a clinical term and histological confirmation is not required for its diagnosis so biopsy was not mandatory for diagnosis in this study.

Statistical analysis

The results obtained were entered in Microsoft Excel sheet and analyzed using the SPSS version 21 IBM Statistical Product and Service Solutions trial pack was used for data analysis. Descriptive statistics were used to formulate the results.


  Results Top


In the present study, the prevalence of leukoplakia was studied in a population of 300 patients. The study sample who presented with leukoplakia had only one female patient showing a male preponderance as shown in [Graph 1]. All the patients were above the age of 40 years. The prevalence [Graph 2] found was 2%. All the patients gave a history of the use of tobacco consumption in different forms.




  Discussion Top


Many studies have been carried out to determine the epidemiology of leukoplakia in different populations. In the present study, out of the 300 patients included in the study, six patients were reported to have leukoplakia [Graph 2]. A Swedish study done by Axell (1976) reported a prevalence of 3.6%, whereas another study carried out in Hungary, the prevalence of leukoplakia varied between 0.6% and 3.6% of the adult population, as reported by Banoczy and Sugar.[10] In a 10-year population-based study, more than 30,000 individuals 15 years of age or older were studied by Gupta et al. in 1980.[12] These individuals were from three areas of India, with an average of 10,000 individuals forming random samples from these three separate communities. These patients were followed annually and examined in a house-to-house survey. The annual incidence per 1000 men ranged from 1.1 to 2.4, whereas in women in the same geographical areas, the incidence ranged from 0.2 to 0.03. It was noted that when reverse smoking was practiced, the incidence of white patches on the palate was 6.3 per 1000 men and 11.2 among women. The most important finding of this study was that tobacco use in one form or another was the most common variable relative to the development of leukoplakia.

The gender distribution of leukoplakia varies widely from one survey to another. In the present study, the prevalence was seen more in male population. Out of six patients, only one was female. This can be assigned to the use of tobacco more commonly in male population. Few studies have also reported a female prevalence more commonly. Such differences in distribution have been attributed to variability in tobacco habits (Reed-Petersen et al., 1972). In a study in the United States, Waldron and Shafer (1975) demonstrated an increased frequency of leukoplakia in women between 1961 and 1975, with the suggestion that this increased frequency may reflect changes in smoking habits during the period of observation. All the patients in the present study were above 40 years of age. This was similar to another study done by Napier et al. where all the patients were of older age group.

The greatest emphasis has been directed toward tobacco as the major etiologic agent in the development of leukoplakia (Pindborg et al., 1977, 1980). In the present study, a similar conclusion regarding the association with the use of tobacco was obtained. All the patients gave a positive history of the use of tobacco. Diagnosis of leukoplakia is done clinically, but brush biopsy, toluidine blue staining, and chemiluminescence be carried out as adjunctive diagnostic methods. The most important parameter in the treatment of leukoplakia is cessation of tobacco and alcohol habits if present. The intervention of leukoplakia depends on the site, size, extent, and associated dysplastic changes and is best left to the treating clinicians.

Limitations

The limitation of the present study was a small sample. This study can be carried out in a larger sample to substantiate the results. Furthermore, there may be a selection bias in the present study as histological confirmation was not carried out. Therefore, further research is required to overcome the foresaid flaws.


  Conclusion Top


The present study demonstrated that the prevalence of leukoplakia is 2% in the defined population. It is associated with the use of tobacco consumption in different forms.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Axéll T, Pindborg JJ, Smith CJ, van der Waal I. Oral white lesions with special reference to precancerous and tobacco- related lesions: Conclusions of an international symposium held in Uppsala, Sweden, May 18-21 1994. International Collaborative Group on Oral White Lesions. J Oral Pathol Med 1996;25:49-54.  Back to cited text no. 1
    
2.
Axell T, Holmstrup P, Kramer I, Pindborg JJ, Shear M. International seminar on oral leucoplakia and associated lesions related to tobacco habits. Community Dent Oral Epidemiol 1984;12:145-54.  Back to cited text no. 2
    
3.
Bouquot JE, Gorlin RJ. Leukoplakia, lichen planus, and other oral keratoses in 23,616 white Americans over the age of 35 years. Oral Surg Oral Med Oral Pathol 1986;61:373-81.  Back to cited text no. 3
    
4.
Axéll T. Occurrence of leukoplakia and some other oral white lesions among 20,333 adult Swedish people. Community Dent Oral Epidemiol 1987;15:46-51.  Back to cited text no. 4
    
5.
Ikeda N, Ishii T, Iida S, Kawai T. Epidemiological study of oral leukoplakia based on mass screening for oral mucosal diseases in a selected Japanese population. Community Dent Oral Epidemiol 1991;19:160-3.  Back to cited text no. 5
    
6.
Reichart PA. Oral mucosal lesions in a representative cross-sectional study of aging Germans. Community Dent Oral Epidemiol 2000;28:390-8.  Back to cited text no. 6
    
7.
Silverman S Jr., Gorsky M, Lozada F. Oral leukoplakia and malignant transformation. A follow-up study of 257 patients. Cancer 1984;53:563-8.  Back to cited text no. 7
    
8.
Lind PO. Malignant transformation in oral leukoplakia. Scand J Dent Res 1987;95:449-55.  Back to cited text no. 8
    
9.
Schepman KP, van der Meij EH, Smeele LE, van der Waal I. Malignant transformation of oral leukoplakia: A follow-up study of a hospital-based population of 166 patients with oral leukoplakia from the Netherlands. Oral Oncol 1998;34:270-5.  Back to cited text no. 9
    
10.
Sugár L, Bánóczy J. Follow-up studies in oral leukoplakia. Bull World Health Organ 1969;41:289-93.  Back to cited text no. 10
    
11.
Warnakulasuriya S, Johnson NW, van der Waal I. Nomenclature and classification of potentially malignant disorders of the oral mucosa. J Oral Pathol Med 2007;36:575-80.  Back to cited text no. 11
    
12.
Gupta PC, Mehta FS, Daftary DK, Pindborg JJ, Bhonsle RB, Jalnawalla PN, et al. Incidence rates of oral cancer and natural history of oral precancerous lesions in a 10-year follow-up study of Indian villagers. Community Dent Oral Epidemiol 1980;8:283-333.  Back to cited text no. 12
    




 

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Abstract
Introduction
Materials and Me...
Results
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Conclusion
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