Clinical features

PVL is an aggressive form of oral leuko-plakia with considerable morbidity and strong predilection to malignant transformation {174,1005,1797,2360}. The etiology of this entity is unknown. The condition develops initially as focal clinical hyperk-eratosis (leukoplakia) that progressively becomes a wide multifocal disease with gross exophytic features {174}. The aver age age at diagnosis is 62 years; women are more commonly afflicted (ratio, 4:1). Typically, multiple oral sites are affected. The most common site in women is the buccal mucosa and the tongue in men. Carcinoma develops after a protracted period of time. The most common sites of the carcinoma are gingiva and tongue. PVL is characterized by high recurrence rate and histological progression. Many cases are resistant to all forms of treatment, including laser microsurgery, surgical excision and radio-and chemotherapy. Conservative management of these lesions has been unsuccessful and wide surgical excision is the best hope for control.

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