An inter-correlative study on clinico-pathological profile and different predisposing factors of oral leukoplakia among the ethnics of Darjeeling, India

Context: Idiopathic leukoplakia is the most common potentially malignant disorder of oral cavity. Owing to the year-wide cold environment in Darjeeling, here the indigenous ethnic people practice a distinct addiction pattern that strongly predisposes them to oral leukoplakia. Aims: The purpose of the present study was to assess the clinico-pathological profile and various predisposing factors involved in oral leukoplakia, and to correlate its exfoliative cytological appearances with the histopathological diagnoses. Materials and Methods: A total of 53 patients were clinically diagnosed with oral leukoplakia during the study period. All information − clinical data pertaining to the patient and the patch, their personal history including addiction and diet, and the cyto-histopathological features of the lesion − was evaluated and methodically compared with each other using the statistical software, Statistical Package for the Social Sciences version 16.0. Results: The female-dominated cohort was chiefly affected with thin leukoplakia (67.9%) involving their buccal mucosa (66.1%). Smokeless tobacco (49.1%) was the most popular addiction. Alcoholism and smoking, increasing daily frequency of tobacco misuse, and verrucous and granular leukoplakias were significantly associated with dysplastic transformation (P < 0.05). Out of 16 (30.2%) dysplastic lesions, exfoliative cytology correctly diagnosed only six (11.3%) cases with a sensitivity of 37.5% only. Conclusion: Verrucous and granular variants are the most detrimental forms of oral leukoplakia. Dysplastic transformation frequently occurs in people addicted to smoking and alcoholism, and verrucous and granular leukoplakia. Lastly, exfoliative cytology poorly predicts the dysplastic evolution within a leukoplakic patch.