Premalignant-lesion-&-Condition-20207231010110.ppt

Pre malignant

1. Premalignant Lesions & Conditions

2. •Premalignant Lesion: A morphologically altered tissue that has more
risk of undergoing malignant transformation than its apparently
normal counterpart.
–Examples: Leukoplakia, Erythroplakia, Actinic keratosis, Palatal
Keratosis associated with reverse smoking, Carcinoma in situ
•Premalignant condition: A generalized state of body that is more
prone for cancer development.
–Examples: Oral Submucous fibrosis, Sideropenic dysphagia,
Syphilis, Discoid lupus erythematosus, Xeroderma pigmentosum,
Lichen planus, Epidermolysis bullosa

3. Leukoplakia
•Leukos-White Plakia-Patch
•A predominantly white lesion of the oral mucosa that cannot
be characterized clinically or pathologically as any other
diagnosable disease; some oral leukoplakia will transform
into cancer

4. Classification
Homogenous
(Uniformly white)
•Smooth
•Furrowed (Fissured)
•Ulcerated
Non Homogenous
(White & Red lesions)
•Verrucous
•Nodular
•Ulcerated

5. Incidence & Epidemiology
•Prevalence of oral soft tissue lesions in tobacco users 4.1%
•Smoker's melanosis is most common soft tissue lesion with the
prevalence being 1.14%.
•Stomatitis nicotina palatini (0.89%) and leukoplakia (0.59%) are
the second and third most common lesions.

6. Incidence & Epidemiology
•Prevalence of all lesions is more common in men when
compared to women, but for chewer's mucosa.
•Among men,
–Smoker's melanosis and
–Stomatitis nicotina palatini
–Leukoplakia
•Among women
–Leukoplakia
–Oral Submucous Fibrosis
•Majority of the lesions are found among people aged from 41 to
60 years.

7. Etiology
•Smoking
•Spirits
•Syphilis
•Sanguinaria
•Sunrays
•Sharp cusps of teeth
•Septicemia
•Galvanism
•Viruses
•Nutrition

8. Clinical features
•M > F
•40 years
•Lip, buccal mucosa, tongue, gingiva, floor of the mouth,
•Early & Mild lesions appear as slightly elevated gray/ grayish
white plaques which may be translucent, fissured, wrinkled, soft
and flat. (preleukoplakia)

9. Clinical features
•Mild/ Thin leukoplakia may seldom show dysplasia on biopsy
may continue unchanged or regress.
•Homogenous/ Thick leukoplakia
Two thirds of the lesions slowly extend laterally, become
thicker, acquire white appearance, become leathery, and
fissure.

10. Clinical features
•Nodular leukoplakia
–1/3 regress and remaining develop increased surface
irregularities
•Verrucous/ Verruciform leukoplakia
–Some lesions show sharp or blunt projections

11. Proliferative Verrucous leukoplakia
•Multiple keratotic plaques with roughened surface projections
•Slow spread and involve other sites
•Persistent growth, eventually become exophytic and verrucous
in nature.
•Most likely to transform into malignancy
•Rarely regress
•F > M 4:1 ratio, usually without habit

13. Erythroleukoplakia
•Some lesions show scattered patches of redness
•Intermixed red and white areas are called erythroleukoplakia
•In such areas the epithelial cells are so immature or atrophic
that they can no longer produce keratin