Topical application of vitamin A to oral leukoplakia: A clinical case series.

Abstract

BACKGROUND:

Due to the possibility of malignant transformation of oral leukoplakia, these lesions must be assessed and managed closely and, if not resolved, must be reassessed on a regular basis.

METHODS:

This study evaluated the use of topical 0.05% vitamin A (tretinoin) acid gel for the treatment of oral leukoplakia. Tretinoin was applied topically 4 times a day for the management of nonmalignant oral white lesions in 26 patients. The clinical response was evaluated in all patients and posttreatment biopsies were performed in ten patients.

RESULTS:

The mean age of the patients at the time of diagnosis was 62 years. Of the 26 patients, 50% were tobacco users. Patients were followed for a mean of 23 months. Approximately 27% of the patients had a complete clinical remission. Recurrence of leukoplakia was observed in approximately 40% of patients in whom complete clinical remission occurred if topical applications were discontinued. A 50% reduction in the clinical grade of leukoplakia from a mean of 2.8 to 1.4 on a scale ranging from 0 (no leukoplakia) to 4 (speckled leukoplakia) was observed. When the pretreatment and posttreatment biopsies from 10 patients were evaluated, no change in the mean histologic grade (between mild and moderate dysplasia) was noted; however, some reduction in the histologic grade was noted in 3 of these patients (30%).

CONCLUSIONS:

The use of topical vitamin A acid showed a limited effect in controlling oral leukoplakia. Further studies are needed to establish the appropriate indication, efficacy, and best choice for chemoprevention agents. Close follow-up of all patients with oral leukoplakia is required.

• Authors: J B Epstein, M Gorsky
• Journal: Cancer (Cancer) Vol. 86 Issue 6 Pg. 921-7 (Sep 15 1999) ISSN: 0008-543X [Print] United States
• PMID: 10491516 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 1999 American Cancer Society.

Chemical References

• Vitamin A

Topics

• Administration, Topical
• Adult
• Aged
• Aged, 80 and over
• Biopsy
• Female
• Gingival Neoplasms (drug therapy, prevention & control)
• Humans
• Leukoplakia, Oral (drug therapy, prevention & control)
• Lip Neoplasms (drug therapy, prevention & control)
• Male
• Middle Aged
• Time Factors
• Tongue Neoplasms (drug therapy, prevention & control)
• Treatment Outcome
• Vitamin A (therapeutic use)