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Keywords:
Candida, leukoplakia, oral mucosa, smoking
Abstract
Oral leukoplakia (OL) is the most common potentially malignant disorder of the oral mucosa. The etiological role of Candida in leukoplakia has been a subject of debate in recent years. Candida invasion has been suggested to be a significant risk factor for malignant transformation of OL and also it may be associated with certain clinical characteristics such as lesion type, size, and site, dysplasia, and tobacco use. Several studies showed that the greater risk of malignant change in women than men. Finally, the management of this common condition remains a variable and includes local, topical, and systemic therapies such as anti-oxidants, carotenoids, and antifungal therapies.
Introduction
Oral leukoplakia (OL) is one among important potentially malignant disorder (PMD) of the oral mucosa. It has been defined as "a predominantly white lesion of the oral mucosa that cannot be characterized as any other definable lesion."[1] Leukoplakia is being recognized by two forms: Homogeneous and the non-homogeneous type. Homogeneous leukoplakia has predominantly white lesion of uniform flat, thin appearance, smooth, wrinkled or corrugated surface throughout the lesion, whereas non-homogeneous leukoplakia has been a mixture of white-and-red lesion that may be either irregularly flat, nodular, or verrucous.[2] Leukoplakia shows characteristic histologic findings such as epithelial hyperplasia, and/or hyperkeratosis, with or without epithelial dysplasia or carcinoma.[3] The pooled estimate of the annual rate of OL malignant transformation is 1.36% (0.69-2.03%).[4] Increased malignant potential may be associated with certain clinical characteristics such as lesion type, size, and site, dysplasia, and tobacco use.
Terminology and Definitions of OL
International attempts to definehefine WHO definition of OL are as follows: Kramer (1978) had recognized the malignant potential ofleukokeratosis and smokers patch and its relationship to pipe smoking.[5] Paget (1860) recognized an association between a white keratotic oral lesion and lingual carcinoma.[5] Kramer (1978) suggested the term leukoplakia describe white raised lesion involving oral mucosa. It was also called as leukoma, smokers patch, leukokeratosis, and ichthyosis.[5]
Butlin (1885) related these lesions to smoking and considered smokers patch to be an early stage of a more advanced white raised lesion that he called as leukoma. Axéll (1996) states leukoplakia as a white patch measuring 5 mm or more which cannot be scrapped off and cannot be attributed...