Proliferative verrucous leukoplakia and unifocal verrucous leukoplakia in China: a comparative retrospective cohort study.

OBJECTIVE

There are limited data regarding the association and differentiation between proliferative verrucous leukoplakia (PVL) and unifocal verrucous leukoplakia (UVL).

METHODS

We retrospectively recruited oral leukoplakia (OL) patients from 2010 to 2024, analyzing the demographic, clinical, histopathological features, and malignant transformation of PVL and UVL.

RESULTS

Among 1756 OL subjects, PVL and UVL accounted for 1.88% and 1.54%, respectively, sharing features like similar age of onset and high dysplasia rates (57.58% vs 55.56%). However, significant differences still existed. Gender ratios were 1:2 in PVL and 2.34:1 in UVL. PVL had lower diagnostic accuracy due to lichenoid lesions in 69.70% of patients and higher biopsy counts (2.19 vs 1.19). Malignant transformation rates were higher in PVL (27.27% vs 11.11%), occurring on the gingiva, while in UVL, it was on the buccal mucosa and tongue.

CONCLUSIONS

PVL and UVL are distinct clinical entities, highlighting the critical need for clinicians to differentiate and closely monitor both.