Proliferative verrucous leukoplakia: A diagnostic dilemma

Oral leukoplakia is one of the most common potentially malignant disorders of the oral cavity. Many variants of oral leukoplakia exist, with oral proliferative verrucous leukoplakia (OPVL) being one. OPVL, a slow growing, long-term progressive lesion was first described in 1985 by Hansen et al. It is an aggressive form of oral leukoplakia with multifocal presentation, high rates of malignant transformation and recurrence. It is a rare clinico-pathological entity, which remains an enigma even today. The term proliferative verrucous leukoplakia (PVL) has been the subject of an ongoing discussion with regard to its definition. Its etiology too remains unclear until date. Tobacco use does not seem to have a significant influence on the appearance or progression of PVL. These lesions are known to occur in both smokers and nonsmokers. In the light of current information available, this article describes the etiology, clinical aspects, histological features, and various diagnostic criteria of OPVL.