Proliferative verrucous leukoplakia

Proliferative verrucous leukoplakia (PVL) is a rare type of oral leukoplakia, where white patches that have a high risk of becoming cancerous develop inside the mouth. It mainly involves the lining inside of the cheeks (buccal mucosa) and tongue. It starts as a white plaque of thickened skin (hyperkeratosis) that eventually spreads and forms rough, wart-like (verrucous) lesions that may look like cauliflower. The lesions are slow-growing and progressive, and more and more difficult to control over time. The risk of becoming cancerous is high, especially, of transforming to squamous cell cancer or verrucous carcinoma. It also has a high chance of coming back after treatment (high recurrence risk). The cause is unknown. In some cases, an association with human papilloma virus (HPV) infection has been noted. PVL is more common in elderly women who have had lesions of leukoplakia for many years. People with PVL should avoid certain factors currently known to be related to the development of oral cancer such as tobacco and alcohol. Treatment is not well established but may include surgery, laser ablation treatments, photodynamic therapy, and medication such as Methisoprinol. Because of the long-term course and high chance of becoming cancerous, people with this disease need to have regular follow-up.