Abstract
Proliferative verrucous leukoplakia (PVL) is a potentially malignant disorder of unknown etiology and has a progressive and multifocal behavior. Characteristically, PVL presents with high rates of recurrence and malignant transformation to squamous cell carcinoma or verrucous carcinoma. We reported 3 cases that initially presented as oral lichenoid lesions spread by the oral mucosa and the microscopic analysis in all cases revealed epithelial hyperplasia and lymphohistiocytic infiltrate in a subepithelial pattern, compatible with a lichen planus diagnosis. However, some years after, some lichenoid areas evolved into dysplastic white lesions and 2 of the patients developed squamous cell carcinoma. We have concluded these to be cases of PVL. Thus, we emphasize that diffuse white lesions of the oral mucosa with a verrucous aspect can present, in the initial phases, clinical pathologic features similar to lichen planus, leading to initial failure to correctly diagnose and treat PVL.
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