White patch on left buccal mucosa. Biopsy showed early squamous cell carcinoma. The lesion is suspicious because of the presence of nodules Nodular<unk>  in right commissure. Biopsy showed severe dysplasia The annual malignant transformation rate of<unk>  rarely exceeds 1%, i.e. the vast majority of oral<unk>  lesions will remain benign. A number of clinical and histopathologic features are associated with varying degrees of increased risk of malignant transformation, although other sources argue that there are no universally accepted and validated factors which can reliably predict malignant change. It is also unpredictable to an extent if an area of<unk>  will disappear, shrink or remain stable. * Presence and degree of dysplasia (mild, moderate or severe/carcinoma in situ). While the degree of dysplasia has been shown to be an important predictor of malignant change, many have challenged its use due to the low predictive value from the lack of objectivity of grading dysplasia. While 10% of<unk>  lesions show dysplasia when biopsied, as many as 18% of oral lesions undergo malignant change in the absence of dysplasia. *<unk>  located on the floor of the mouth, the posterior and lateral tongue, and the retromolar areas (the region behind the wisdom teeth) have higher risk, whereas white patches in areas such as the top surface of the tongue and the hard palate do not have significant risk. Although these "high risk" sites are recognized, statistically,<unk>  is more common on the buccal mucosa, alveolar mucosa, and the lower labial mucosa.<unk>  of the floor of the mouth and tongue accounts for over 90% of<unk> s showing dysplasia or carcinoma on biopsy. This is thought to be due to pooling of saliva in the lower part of the mouth, exposing these areas to more carcinogens held in suspension. * Red lesions (erythroplasia) and mixed red and white lesions (erythroleukoplakia/"speckled<unk> ") have a higher risk of malignant change than homogenous<unk> . * Verrucous or nodular areas have a higher risk. * Although smoking increases risk of malignant transformation, smoking also causes many white patches with no dysplasia. This means that statistically, white patches in non-smokers have a higher risk. * Older people with white patches are at higher risk. * Larger white patches are more likely to undergo malignant transformation than smaller lesions. * White patches which have been present for a long period of time have a higher risk. * Persons with a positive family history of cancer in the mouth. * Candida infection in the presence of dysplasia has a small increased risk. * A change in the appearance of the white patch, apart from a change in the color, has a higher risk. Changes in the lesion such as becoming fixed to underlying tissues, ulceration, cervical lymphadenopathy (enlargement of lymph nodes in the neck), and bone destruction may herald the appearance of malignancy. * White patches present in combination with other conditions that carry a higher risk (e.g. oral submucous fibrosis), are more likely to turn malignant. * Although overall, oral cancer is more common in males, females with white patches are at higher risk than men.
Leukoplakia
Lichen planus
Malakoplakia
Oral candidiasis
Hairy leukoplakia
Keratosis
Polypill
Geographic tongue