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Oral Dis 2021 May 19. Epub 2021 May 19.

Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK.

Objectives: To investigate the available evidence on the malignant transformation (MT) of oral proliferative verrucous leukoplakia (PVL).

Material And Methods: We searched six main electronic and three grey literature databases in a two-phase process. Cohort studies investigating MT of PVL were eligible for inclusion. Read More

Indian J Dermatol Venereol Leprol 2021 May-Jun;87(3):455

Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Tanta University, Tanta, Egypt.

J Clin Med 2021 Apr 13;10(8). Epub 2021 Apr 13.

Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain.

This study aimed to investigate the role of a panel of salivary cytokines as biomarkers for early detection oral squamous cell carcinoma (OSCC), comparing their levels among healthy individuals, patients with oral leukoplakia (OL), and malignant lesions. Cytokine profiling analysis performed in a minimally invasive sample was correlated with clinicopathological variables in our patient cohorts. Unstimulated saliva was obtained from subjects with OSCC at early ( = 33) and advanced ( = 33) disease, OL with homogeneous ( = 33) and proliferative verrucous ( = 33) clinical presentations, and healthy controls ( = 25). Read More

J Oral Pathol Med 2021 Mar 25. Epub 2021 Mar 25.

Department of Stomatologia and Maxillofacial Surgery, University Hospital of Valencia, Spain.

Background: A systematic review and meta-analysis were made of the incidence of recurrences in patients with proliferative verrucous leukoplakia (PVL) subjected to different types of treatment.

Methods: The study was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. A literature search was made in the Medline (PubMed), EMBASE, and Web of Science databases, together with a manual search, covering the period from 1985 to January 2020, with no language restrictions. Read More

Prim Dent J 2021 Mar;10(1):10-12

Consultant in Oral Medicine Honorary Professor, University Dental Hospital of Manchester, Central Manchester University Hospitals NHS Foundation Trust, Manchester, and School of Dentistry, University of Manchester.

Oral cancer is a significant cause of morbidity and mortality worldwide. In this article we present two cases of potentially innocuous looking lesions, initially thought to be traumatic in origin, but later diagnosed as cancer. The first patient presented with a persistent laceration thought to be caused by an accidental shaving injury, which was subsequently diagnosed as squamous cell carcinoma. Read More

Oral Oncol 2021 May 28;116:105191. Epub 2021 Feb 28.

CIBERONC, Valencia, Spain; Medicina Oral Unit, Stomatology Department, Valencia University, Spain; Department of Stomatology and Maxillofacial Surgery, Hospital General Universitario de Valencia, Valencia, Spain. Electronic address:

Objectives: To explore the pathophysiology of proliferative verrucous leucoplakia (PVL) through a methylated DNA immunoprecipitation and high-throughput sequencing (MeDIP-seq) case-control study.

Materials And Methods: Oral biopsies from ten PVL patients and five healthy individuals were obtained and used to compare their epigenetic patterns. Network biology methods and integrative analyses of MeDIP-seq and RNAseq data were applied to investigate functional relations among differentially methylated genes (DMGs). Read More

Arch Immunol Ther Exp (Warsz) 2021 Feb 27;69(1). Epub 2021 Feb 27.

Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Dr. Qarib St, Keshavarz Blvd, 14194, Tehran, Iran.

Cancer is one of the most serious diseases affecting health and the second leading cause of death worldwide. Despite the development of various therapeutic modalities to deal with cancer, limited improvement in overall survival of patients has been yielded. Since there is no certain cure for cancer, detection of premalignant lesions, and prevention of their progression are vital to the decline of high morbidity and mortality of cancer. Read More

Oral Oncol 2021 May 13;116:105144. Epub 2021 Jan 13.

Department of Oral Diagnosis, Semiology and Pathology Areas, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.

This report aimed to describe an uncommon case of verrucous carcinoma of the oral cavity with a unique presentation of proliferative verrucous leucoplakia. An 82-year-old female presented multiple white plaques in the oral cavity, which have been treated as candidiasis without resolution. The biopsy specimen demonstrated a well-defined squamous cell epithelium with verrucous aspects. Read More

Oral Dis 2021 May 9;27(4):803-812. Epub 2020 Sep 9.

Australian Centre for Oral Oncology Research & Education, Nedlands, WA, Australia.

Oral leukoplakia (OLK) and its more aggressive clinical variant proliferative verrucous leukoplakia (PVL) remain enigmatic disorders clinically and histopathologically. Despite decades of research into both, there has been only incremental advancement in our understanding of their aetiology and pathogenesis and only minimal improvement in effective management strategies. Currently, no specific prognostic genetic or molecular marker has been reported for leukoplakia. Read More

Head Neck Pathol 2021 Jun 7;15(2):572-587. Epub 2021 Jan 7.

Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA.

The many diverse terms used to describe the wide spectrum of changes seen in proliferative verrucous leukoplakia (PVL) have resulted in disparate clinical management. The objective of this study was to produce an expert consensus guideline for standardized assessment and reporting by pathologists diagnosing PVL related lesions. 299 biopsies from 84 PVL patients from six institutions were selected from patients who had multifocal oral leukoplakic lesions identified over several years (a minimum follow-up period of 36 months). Read More

South Asian J Cancer 2020 Jun 14;9(2):99-104. Epub 2020 Dec 14.

Department of Oral Pathology, North Bengal Dental College and Hospital, Darjeeling, West Bengal, India.

 Early detection of dysplastic changes within oral potentially malignant disorders is the mainstay to prevent oral cancer. Ki-67 is one of the most useful antigens in this purpose.  The study aims were to recognize and mutually compare the proliferative status of idiopathic oral leukoplakia (OL) patches, which presented through different forms of dysplasia and carcinoma. Read More

J Oral Pathol Med 2021 Feb 30;50(2):129-135. Epub 2020 Dec 30.

Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, WHO Collaborating Centre for Oral Cancer, London, UK.

Background: Multiple white plaques of the oral mucosa are usually associated with potentially malignant disorders such as oral lichen planus, oral lichenoid lesions and proliferative verrucous leukoplakia. Previous studies in the current literature describe a potential clinical overlap in these entities. The aim of this study is to review clinicopathological and evolutive features of these Oral Potentially Malignant Disorders highlighting the dynamic changes of diagnoses. Read More

J Oral Pathol Med 2021 Feb 8;50(2):229-235. Epub 2021 Jan 8.

Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, WHO Collaborating Centre for Oral Cancer, London, UK.

Background: Recognition and differentiation of early forms of proliferative verrucous leukoplakia (PVL) could be a challenge to both clinicians and pathologists.

Objective: To report on a retrospective study that was carried out on 51 cases of PVL that were initially diagnosed as frictional keratosis, oral leukoplakia or oral lichen planus. A secondary objective is to report on the outcome of malignant transformation during follow-up. Read More

Oral Dis 2020 Oct 31. Epub 2020 Oct 31.

Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast, Qld, Australia.

Oral potentially malignant disorders (OPMDs) are associated with an increased risk of occurrence of cancers of the lip or oral cavity. This paper presents an updated report on the nomenclature and the classification of OPMDs, based predominantly on their clinical features, following discussions by an expert group at a workshop held by the World Health Organization (WHO) Collaborating Centre for Oral Cancer in the UK. The first workshop held in London in 2005 considered a wide spectrum of disorders under the term "potentially malignant disorders of the oral mucosa" (PMD) (now referred to as oral potentially malignant disorders: OPMD) including leukoplakia, erythroplakia, proliferative verrucous leukoplakia, oral lichen planus, oral submucous fibrosis, palatal lesions in reverse smokers, lupus erythematosus, epidermolysis bullosa, and dyskeratosis congenita. Read More

Head Neck Pathol 2021 Jun 16;15(2):443-460. Epub 2020 Sep 16.

Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.

The current WHO histopathologic criteria for oral epithelial dysplasia (ED) are based on architectural and cytologic alterations, and do not address other histopathologic features of ED. Here we propose new diagnostic criteria including architectural, organizational, and cytologic features for oral ED. Cases of unifocal leukoplakia (UL) and proliferative leukoplakia (PL) with clinical photographs and follow-up information were identified. Read More

Clin Oral Investig 2021 May 11;25(5):2645-2657. Epub 2020 Sep 11.

Medicina Oral Unit, University General Hospital Valencia University, Valencia, Spain.

Objectives: To explore the pathophysiology of proliferative verrucous leukoplakia, a rare oral disorder that exhibits high rates of recurrence and malignant transformation, through a RNAseq case-control study.

Material And Methods: We obtained oral biopsies from 10 patients with verrucous leukoplakia lesions and from the mucosa of 5 healthy individuals for sequencing using RNAseq technology. Using bioinformatic methods, we investigated gene expression and enrichment differences between patients both with and without the disorder. Read More

J Periodontol 2021 02 14;92(2):273-285. Epub 2020 Aug 14.

Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL.

Background: Potentially malignant lesions of the gingiva may frequently present as well-demarcated white lesions confined to the marginal gingiva. These lesions often become thick and verrucoid and spread along the marginal gingiva to encircle the tooth. Some cases of marginal gingival leukoplakia, over time, progress to extensively involve the gingiva fulfilling the criteria for proliferative verrucous leukoplakia (PVL). Read More

Arkh Patol 2020 ;82(3):13-17

Peoples' Friendship University of Russia(RUDN university), Moscow, Russia.

Aim Of Study: To study of neoplastic transformation of the epithelial cells of the oral mucosa with verrucous hyperortokeratosis, verrucous carcinoma and oral squamous cell carcinoma (OSCC).

Materials And Methods: Oral mucous membrane biopsies of 33 patients with clinical diagnosis of proliferative verrucous leukoplakia were investigated. Histologically in 19 cases (57. Read More

Int J Oral Maxillofac Surg 2021 Jan 23;50(1):14-20. Epub 2020 Jun 23.

Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy. Electronic address:

Proliferative verrucous leukoplakia (PVL) is a rare and refractory form of oral mucosal leukoplakia of unknown origin, characterized by high rates of malignant transformation. Different diagnostic criteria, terminologies, and therapeutic approaches have been proposed since the first report in 1985. There remains no general agreement regarding the clinical and histological diagnosis, prevention, and correct management of this disease. Read More

J Am Dent Assoc 2020 08 26;151(8):e62. Epub 2020 May 26.

Oral Dis 2021 May 12;27(4):848-880. Epub 2020 May 12.

Australian Centre for Oral Oncology Research & Education, Perth, WA, Australia.

Objective: To systematically review retrospective studies examining prognostic potentials of candidate biomarkers to stratify malignant progression of oral leukoplakia (OL) and proliferative verrucous leukoplakia (PVL).

Materials And Methods: A systematic literature search of PubMed, EMBASE, Evidence-Based Medicine and Web of Science databases targeted literature published through 29 March 2018. Inter-rater agreement was ascertained during title, abstract and full-text reviews. Read More

Oral Dis 2021 Apr 30;27(3):431-438. Epub 2020 Mar 30.

Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.

Objectives: We aimed to provide pooled estimates of human papillomavirus (HPV) prevalence in oral potentially malignant disorders (OPMD) and evaluate the impact of presence of epithelial dysplasia.

Methods: We searched PubMed, Embase, and Cochrane Library databases for studies that examined the prevalence of HPV DNA in OPMD tested by polymerase chain reaction (PCR).

Results: Across 52 eligible studies (2,677 cases), we found an overall pooled HPV prevalence of 22. Read More

J Oral Pathol Med 2020 May 9;49(5):404-408. Epub 2020 Feb 9.

School of Dentistry, University of Barcelona, Spain/Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain.

Objective: The aim of this systematic review was to gather the available evidence about proliferative verrucous leukoplakia. This systematic review was conducted to answer the question: "What are the main clinical features of PVL patients?".

Material And Methods: A systematic review of the literature was done following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements. Read More

Head Neck 2020 03 5;42(3):539-555. Epub 2019 Dec 5.

Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania.

Importance: Potentially malignant disorders of the oral cavity (OPMD) are a heterogeneous group of lesions associated with a variable risk of malignant transformation (MT) to invasive cancer. Leukoplakia (LE), lichen planus (LP), oral lichenoid lesions (OLL), oral erythroplakia (OE), oral submucous fibrosis (OSF), and proliferative verrucous leukoplakia (PVL) are among the most common of these lesions. Oral dysplasia is a mucosal area characterized by cellular and architectural derangement, which may be associated with OPMDs or not. Read More

Case Rep Dent 2019 22;2019:5785060. Epub 2019 Oct 22.

Department of Oral Medicine & Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka.

This report describes a case of proliferative verrucous leukoplakia (PVL) of the gingiva with no discernible aetiology, which presented in a 36-year-old female. The initial nonscrapable gingival lesion was treated with CO laser ablation, and the histopathological evaluation was carried out. The presence of koilocytic cells in the superficial epithelium led to immunohistochemical investigations with p16 antibody, which showed strong nuclear positivity and slight cytoplasmic positivity in >50% of the cells with >25% confluency. Read More

Med Oral Patol Oral Cir Bucal 2019 Nov 1;24(6):e799-e803. Epub 2019 Nov 1.

Department of Oral and Maxillofacial Surgery and Oral Pathology VU University Medical Center P.O. Box 7057, 1007 MB Amsterdam, The Netherlands

There is a distinct lack of uniformity in the definitions and clinical terminologies related to oral leukoplakia and leukoplakialike lesions and disorders. Proposals have been put forward to subclassify leukoplakia into a homogeneous and a non-homogeneous type based on color only, being either predominantly white or mixed whiteand-red, respectively, irrespective of the texture of the lesion. In this proposal there is no need anymore to regard the poorly defined proliferative verrucous leukoplakia as a separate entity. Read More

Pathol Res Pract 2019 Dec 25;215(12):152670. Epub 2019 Sep 25.

Rambam medical center, Department of pathology, HaAliya HaShniya St 8, Haifa, 3109601, Haifa, Israel; Technion school of medicine, HaAliya HaShniya St 8, Haifa, 3109601, Haifa, Israel.

Objective: Proliferative verrucous leukoplakia is classified as a potentially malignant disorder because of its high rate of malignant transformation. PVL progresses in a series of clinical stages where the early stage represents multiple, multifocal leukoplakias with a high recurrence rate. The intermediate and late stages are clinically exophytic lesion, diagnosed microscopically as verrucous hyperplasia that often progresses into verrucous carcinoma and/or squamous cell carcinoma. Read More

J Oral Maxillofac Pathol 2019 May-Aug;23(2):248-256

Department of Oral and Maxillofacial Pathology, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India.

Background: Oral cancer is said to be the 6th most common cancer in men and 12th in women. Potentially malignant disorders/potentially premalignant oral epithelial lesion (PMDs/PPOELs) have shown an increased risk of progressing to cancer. In this regard, lack of awareness about identification of oral PMDs among healthcare providers in general and oral pathologists in particular is said to be responsible for the diagnostic delay. Read More

Clin Oral Investig 2020 Jun 22;24(6):1963-1969. Epub 2019 Aug 22.

Oral Medicine, Valencia University, Valencia, Spain.

Objectives: To describe the number of second primary malignancies in a series of 33 patients with proliferative verrucous leukoplakia (PVL), detailing the mean time between primary malignancies and their clinical characteristics.

Materials And Methods: Two groups of patients were included in this study: group 1 comprised 33 PVL patients who had developed ≥ 2 oral squamous cell carcinoma (OSCC) and group 2 comprised 48 PVL patients without malignant degeneration. We compared the groups with regard to age, gender, oral location, and number of oral sites affected. Read More

Surg J (N Y) 2019 Jul 5;5(3):e69-e75. Epub 2019 Aug 5.

Department of Otolaryngology, San Paolo Hospital, University of Milan, Milan, Italy.

 Because of its affinity for water-based tissues, carbon dioxide (CO ) laser has become an instrument of choice for treating oral mucosa conditions, ranging from inflammatory to malignant lesions. The aim of this work is to systematically evaluate the outcomes of laser surgery over a wide range of lesions, while providing a solid and reproducible protocol for CO laser surgery in the outpatient management of oral lesion.  Seventy-eight patients underwent 92 laser outpatient procedures for treatment of a wide range of benign and malignant lesions. Read More