Proliferative Verrucous Leukoplakia — MFDS Part 1 MCQ
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Correct answer: A — It usually follows a multifocal progressive course, frequently recurs and has the highest malignant transformation risk among oral potentially malignant disorders
Proliferative verrucous leukoplakia is characterised by multifocality, relentless clinical progression, frequent recurrence after treatment and an exceptionally high risk of malignant transformation. A meta-analysis estimated a pooled transformation proportion of approximately 44%, the highest among oral potentially malignant disorders. Early biopsies may show only hyperkeratosis or mild dysplasia, so bland initial histology does not exclude substantial future risk. Local irritant removal does not usually produce regression, and disease is not confined to the tongue; the gingiva and buccal mucosa are commonly involved. Its aetiology is not attributable to a single HPV subtype, and it is not a candidal disorder responsive to antifungal therapy. Long-term specialist surveillance with repeat biopsy of changing areas is therefore required.
Reference: Ramos-García P et al. Malignant transformation of oral proliferative verrucous leukoplakia: A systematic review and meta-analysis. Oral Diseases. 2021;27(8):1896-1907. https://pubmed.ncbi.nlm.nih.gov/34009718/