Leukoplakia Definition — ORE Part 1 MCQ

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ModerateOral MedicineLeukoplakia DefinitionORE Part 1

A patient has a persistent white plaque on the buccal mucosa. It cannot be removed by scraping, and clinical examination does not support candidosis, lichen planus, frictional trauma or a tobacco-associated lesion. Which diagnosis is most appropriate?

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Correct answer: D — Oral leukoplakia

The correct answer is **A. Oral leukoplakia**. Leukoplakia is a clinical diagnosis of exclusion: it describes a predominantly white patch or plaque that cannot be characterised clinically or pathologically as another disorder. The stem deliberately excludes the main competing explanations. Oral candidosis is usually removable on wiping, whereas this plaque is not. Oral lichen planus would usually show a characteristic reticular, erosive or plaque-pattern presentation rather than an otherwise unclassifiable isolated plaque. Frictional keratosis requires a relevant mechanical source, and tobacco-associated keratosis requires a corresponding tobacco exposure pattern. Once these alternatives have been excluded, the appropriate diagnosis is oral leukoplakia. Persistent lesions require appropriate specialist assessment and consideration of biopsy to establish histopathology and assess dysplasia.

Reference: van der Waal I. Oral leukoplakia, the ongoing discussion on definition and terminology. Medicina Oral Patología Oral y Cirugía Bucal. 2015. https://pubmed.ncbi.nlm.nih.gov/26449439/