Credit: These cases were adapted from Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013. You can now get the second edition of the Color Atlas of Family Medicine as an app for mobile devices by clicking this link: usatinemedia.com.
1. A painless white, thick lesion with fissuring had been on the side of this 57-year-old man’s tongue for the past 7 months. The patient drinks two to three beers in the evening and smokes one pack of cigarettes a day.
Diagnosis: This patient was given a diagnosis of leukoplakia and the biopsy indicated that the lesion was premalignant. The World Health Organization defines leukoplakia as “white plaques of questionable risk” in cases where other known diseases that don’t carry an increased risk for cancer have been excluded. For all types of leukoplakia, the risk of malignant transformation is approximately 1%, with a much higher risk associated with leukoplakias that contain red spots and/or rough spots.
For more information, read “White patch on tongue.” J Fam Pract. 2014.