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CORRELATIONS BETWEEN CLINICAL AND
MICROSCOPIC FEATURES OF PREMALIGNANT
LESIONS
Done by : Ahmed Ali Al-Asmari
Idiopathic Leukoplakia :
Clinical features :
Asymptomatic white patch; cannot be wiped off; males affected more than females
- Age
Usually over 40 years
- High-Risk Sites for Malignant Transformation
Floor > tongue > lip > palate > buccal > vestibule > retromolar
Microscopic Diagnoses At First Diagnosis
Hyperkeratosis—80%
Dysplasia—12%
In situ carcinoma—3%
Squamous cell carcinoma—5%
Erythroplakia :
Clinical features :
Asymptomatic red velvety patch; red lesions may have foci or white hyperkeratosis (speckled erythroplakia)
- Age
typically between 50 and 70 years
- High-risk sites
floor of mouth, tongue, retromolar mucosa, soft palate
Histopathology
Squamous cell carcinoma (50%)
Severe dysplasia or in situ carcinoma (40%)
Mild-to-moderate dysplasia (10%)
Lichen planus :
Clinical features :
asymptomatic except when erosions are present; occasionally present and are purple pruriticpapules; forearm and lower leg most common skin areas
- Age
seen in middle age
- High-risk sites
buccal mucosa most commonly affected, with lesions occasionally on tongue, gingiva, and palate; skin lesions
Possible Risk of Carcinoma Transformation
May be slightly increased with erosive form (0.4%–2.5% of cases)
Reference :
Oral Pathology : Clinical Pathologic Correlations by Joseph A. Regezi , James J. Sciubba , and Richard C.K. Jordan , 5th ed2007 , Saunders Company , Chapter 4 , Page 100-130