Clinical evolution of proliferative verrucous leukoplakia [Evoluzione clinica della leucoplachia proliferativa verrucosa]

OBJECTIVES. Proliferative verrucous leukoplakia (PVL) is a particular type of leukoplakia thought to be at high risk of malignant transformation. The aim of this review is to update the reader about PVL. MATERIALS AND METHODS. A search of PubMed database was undertaken with the following keywords: proliferative verrucous leukoplakia, oral leukoplakia. RESULTS AND CONCLUSIONS. PVL seems to be a multifactorial disease, usually associated with HPV infection. The early clinical manifestation of PVL is a flat white or speckled keratotic lesion, with a grainy or verrucous surface. Successive stages are characterized by multifocal lesions, increasingly exophytic and verruciform, affecting mainly the buccal mucosa and the tongue dorsum. Diagnosis is retrospective. The frequency of malignant transformation is higher in PVL than in leukoplakia and cannot be reduced by treatments proposed. Accurate follow-up and frequent biopsies are probably the best ways of approaching the subjects affected by PVL.