Oral leukoplakia in a South African sample: a clinicopathological study

Abstract

DEDICATIONThis thesis is dedicated to my parents for their belief in me, to my wife for her unconditional love and support and to my daughter.iii ABSTRACT Oral leukoplakia is the most common potentially malignant oral lesion. While the clinicopathological features in white patients are well characterised, this is not the case in black people. The aim of this study is to analyse the differences in the clinicopathological features of oral leukoplakia in different racial groups in the greater Johannesburg area of South Africa, with special emphasis on the black population. Only 14% of oral leukoplakia occurred in black persons compared to 80% in white persons. In contrast to white persons, black persons were diagnosed with oral leukoplakia at a younger age; there were more males affected than females; and the proportion of idiopathic leukoplakias was greater. There were significantly more black people (23%) with non-homogenous leukoplakia oral leukoplakia than white people with non-homogenous leukoplakia (13%), but there were significantly more white people (51%) than black people (23%) with dysplastic oral leukoplakia; and while in white people the floor of the mouth was the most frequently affected site, in black people it was the buccal mucosa. This study provides important differences in the clinicopathological features of oral leukoplakia between black persons and white persons.iv ACKNOWLEDGEMENTS I gratefully acknowledge Professor Shabnum Meer for her expert guidance and steadfast support.

Oral leukoplakia in the Sudan: clinicopathological features and risk factors

“…This study revealed that OL was more frequent in males than females, and this was consistent with the majority of reports in the literature. In the Sudan, smoking and Toombak dipping habits remain socially unaccepted among females, a fact that explains the greater number of cases of OL who are male.…”

Long-term outcome of non-surgical treatment in patients with oral leukoplakia

“…Previous studies have reported that men underwent malignant transformation more frequently than women [15,16]. In the present study, the expansion of lesion and malignant transformation were more frequent in men than in women.…”

“…Several studies have evaluated the clinicopathological factors predictive of malignant transformation in patients with oral leukoplakia and demonstrated significant differences in age, gender, cite of lesion, size of lesion, number of sites affected, and clinical and pathological appearance of the lesions [12][13][14][15][16][17][18][19]. In the present study, the lesions that were non-homogenous and located on the tongue presented with a higher grade were likely to progress into cancer.…”

“…Table 3 showed that 16 of 25 lesions (64.0%) by smoking cessation and 9 of 17 lesions (52.9%) by occlusal adjustment were led in reduction and disappearance. Smoking cessation was one of the most important factors found to increase the disappearance of oral leukoplakia, as reported previously [1,15,16]. It is very difficult to establish whether the lesions had an actual correlation with smoking because of the difference in the smoking amount, frequency, race, and many other factors modifying the risk of oral preneoplasia and cancer.…”

Oral squamous cell carcinoma in a South African sample: Race/ethnicity, age, gender, and degree of histopathological differentiation

“…[32,34] However, it has become clear that the histopathological information gained from multiple biopsies taken from different parts of the invasive front of the cancer has a more significant prognostic value. [35] In the population of greater Johannesburg in South Africa, oral leukoplakia occurs significantly more frequently in white than in black persons, [17,36] but as this study shows that black and white persons are affected by OSCC more or less equally, it is reasonable to assume that in Johannesburg, OSCC develops de novo more frequently in blacks than in whites. This suggests that in some way the pathogenesis of OSCC may be different in black and white persons.…”