Title: Oral Leukoplakia in Arab Countries: A Review

Authors: Zainah Alshehri, Ashraf Elmetwally, Lubna Alnasser

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i2.122

Abstract

Oral Leukoplakia (OL) is a term describing the white lesions of the oral mucosa; it is the most common potentially malignant lesion of the oral cavity. The epidemiology of this condition in Arab countries is not well studied. A computer-based search for literature through pub-med was performed using relevant keywords to retrieve studies conducted in Arab world related to OL. After searching PubMed database, local journals and cross-referencing; a total of 12 articles were used for this review. Eight studies were cross-sectional, of them, two studies estimated a prevalence that ranged between 1.9% and 3.6%. Studies about various risk factors and prognostic marker were conducted in a clinical setting using case-control design (n=4). Cultural determinants such as certain smokeless tobacco habits (e.g. Qat and Shammah chewing) and Cigarette smoking were among factors investigated in some Arab countries. The results demonstrate a strong relationship between OL and Qat and Shammah Chewing (OL prevalence was 22-27% among tobacco users). Further population-based studies should be conducted in Arab countries to identify a causal relationship between these factors and the development, onset and progression of OL.

Keywords: Oral leukoplakia; Arab; epidemiology; premalignant; prevalence.

References

  1. WHO Collaboration Centre for Oral Precancerous Lesions. Definition of leukoplakia and related lesions: an aid to studies on oral precancer.Oral Surg. 1978; 46: 518
  2. Suarez P, Batsakis JG, El-Naggar AK. Leukoplakia: still a gallimaufry or is progress being made?--A review. Advances in anatomic pathology. 1998;5(3):137-55.
  3. Neville BW, Damm DD, Allen C, Bouquot J. Dermatologic diseases. Oral and maxillofacial pathology. 2009;3:776-9.
  4. Warnakulasuriya S, Johnson N, Van der Waal I. Nomenclature and classification of potentially malignant disorders of the oral mucosa. Journal of oral pathology & medicine. 2007;36(10):575-80.
  5. Reichart PA. Identification of risk groups for oral precancer and cancer and preventive measures. Clinical oral investigations. 2001;5(4):207-13.
  6. Petti S. Pooled estimate of world leukoplakia prevalence: a systematic review. Oral oncology. 2003;39(8):770-80.
  7. Van der Waal I. Potentially malignant disorders of the oral and oropharyngeal mucosa; terminology, classification and present concepts of management. Oral oncology. 2009;45(4):317-23.
  8. Baric JM, Alman JE, Feldman RS, Chauncey HH. Influence of cigarette, pipe, and cigar smoking, removable partial dentures, and age on oral leukoplakia. Oral Surgery, Oral Medicine, Oral Pathology. 1982;54(4):424-9.
  9. Mani N. Preliminary report on prevalence of oral cancer and precancerous lesions among dental patients in Saudi Arabia. Community dentistry and oral epidemiology. 1985;13(4):247-8.
  10. Salem G. Leukoplakia and tobacco habits in Gizan, Saudi Arabia. Saudi Dent J. 1992;4(2):50-4.
  11. Ali AA, Al‐Sharabi AK, Aguirre JM, Nahas R. A study of 342 oral keratotic white lesions induced by qat chewing among 2500 Yemeni. Journal of oral pathology & medicine. 2004;33(6):368-72.
  12. Scheifele C, Nassar A, Reichart P. Prevalence of oral cancer and potentially malignant lesions among shammah users in Yemen. Oral oncology. 2007;43(1):42-50.
  13. Ali M, Joseph B, Sundaram D. Prevalence of oral mucosal lesions in patients of the Kuwait University Dental Center. The Saudi dental journal. 2013;25(3):111-8.
  14. Al-Attas SA, Ibrahim SS, Amer HA, Darwish ZE-S, Hassan MH. Prevalence of potentially malignant oral mucosal lesions among tobacco users in Jeddah, Saudi Arabia. Asian Pacific Journal of Cancer Prevention. 2014;15(2):757-62.
  15. Abd-Sada AS. Prevalence" of" common" white" lesions" in" oral"" cavity" among" pa: ents" aEended" School" of" Den: stry" in" Sulaimani/" Iraq. Sulaimani Dental Journal.35.
  16. Al-Sharabi AK. Conditions of oral mucosa due to takhzeen al-qat. Yemeni Journal for Medical Sciences. 2011;5:1-6.
  17. Ahmed HG, Mahgoob RM. Impact of Toombak dipping in the etiology of oral cancer: Gender-exclusive hazard in the Sudan. Journal of cancer research and therapeutics. 2007;3(2):127.
  18. Al-Mohaya M, Darwazeh A, Bin-Salih S, Al-Khudair W. Oral lesions in Saudi renal transplant patients. Saudi Journal of Kidney Diseases and Transplantation. 2009;20(1):20.
  19. Yarom N, Epstein J, Levi H, Porat D, Kaufman E, Gorsky M. Oral manifestations of habitual khat chewing: a case-control study. OralSurgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2010;109(6):e60-e6.
  20. Anass MA, Ahmed HG. A case-control study of oral epithelial proliferative markers among Sudanese Toombak dippers using micronuclei assay, argyrophilic nucleolar organizer region, Papanicolaou and crystal violet methods. Rare tumors. 2013;5(3).
  21. Bassiony MM. Smoking in Saudi Arabia. Saudi medical journal. 2009;30(7):876-81.
  22. Jarallah JS, Al-Rubeaan KA, Al-Nuaim ARA, Al-Ruhaily AA, Kalantan KA. Prevalence and determinants of smoking in three regions of Saudi Arabia. Tobacco control. 1999;8(1):53-6.
  23. Scheifele C, Reichart PA, Dietrich T. Low prevalence of oral leukoplakia in a representative sample of the US population. Oral oncology. 2003;39(6):619-25.
  24. Hashibe M, Sankaranarayanan R, Thomas G, Kuruvilla B, Mathew B, Somanathan T, et al. Alcohol drinking, body mass index and the risk of oral leukoplakia in an Indian population. International journal of cancer. 2000;88(1):129-34.
  25. Scully C (1985). Dermatologic Manifestation of Oral Leukoplakia. Medscape.com. retrieved Dec 10, 2013, from http://emedicine.medscope.com.

Corresponding Author

Zainah Alshehri

Ministry of Health, Quality Coordinator