SUCCESSFUL LONG-TERM MANAGEMENT OF PROLIFERATIVE VERRUCOUS LEUKOPLAKIA: A CASE REPORT

Abstract

<h3>Introduction</h3> Proliferative verrucous leukoplakia (PVL) is a rare condition that is difficult to diagnose, difficult to treat, and often progresses to malignancy. We present a case of PVL followed over twelve years that was managed both surgically and medically, impacting this patient's dental treatment options and overall quality of life. <h3>Objectives</h3> Retinoic acid can help manage PVL when part of a comprehensive treatment plan, including selec- tive surgical excisions in the form of biopsies, because it may inhibit epithelial proliferation and keratinization. New research has shown that conservative management and routine close follow-up by a "multidisciplinary team" may have similar outcomes with less morbidity compared to routine surgical excisions, but uncertainty about recur- rence restricts treatment options. <h3>Findings</h3> This case illustrates successful management of a very difficult condition to treat. Despite a tendency to recur and evolve, this patient's PVL remained relatively stable by diligent topical retinoid application, selective biopsy, and strict follow-up. Although the patient lost teeth due to a yet unknown mechanism, the PVL did not transform to VC or OSCC. Living with PVL has had a profound effect on this patient's oral functional capacity and quality of life. The patient was not advised to replace missing teeth with implants, and dental treatment was prolonged due to uncertainty about the condition. <h3>Significance for Practice</h3> The purpose of this case report is to present a case of PVL, managed conservatively, and suggest that clinicians should not rush to surgery. Still, this case illustrates that quality of life is affected as treatment options for missing teeth are limited.