From the Guidelines

Leukoplakia is a potentially malignant oral lesion that requires prompt diagnosis and treatment to prevent malignant transformation.

Leukoplakia is defined as a predominantly white patch or plaque of the oral mucosa that cannot be wiped away and is not clinically or histologically characterized as any other definable disorder 1.
It is clinically divided into two types, homogeneous and nonhomogeneous, with nonhomogeneous leukoplakia having a higher risk of malignant transformation 1.

The main purpose of treatment is to prevent malignant transformation and reduce or eliminate the lesion 1.
Treatment approaches include non-surgical and surgical methods, but there is insufficient evidence to determine which approach is better 1.
Photodynamic therapy (PDT) has emerged as a promising alternative treatment with minimal invasiveness, efficacy, and low risk of systemic side effects and disfigurement 1.
Topical 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) is a recommended approach, with studies showing positive clinical effects and no recurrence at follow-up 1.
Surgical methods, such as traditional excision, electrocauterization, and carbon dioxide laser ablation, may be considered, but are less feasible for extensive or anatomically sensitive lesions 1.

From the Research

Leukoplakia is a white patch or plaque on the mucosa of the oral cavity that cannot be removed and cannot be clinically or microscopically explained by the presence of a disease 2
The diagnosis is usually evident from the clinical presentation and histopathology, with most white lesions being benign 3
Histopathology of leukoplakia can disclose hyperkeratosis with dysplasia or carcinoma, or hyperkeratosis or parakeratosis without dysplasia 3
Basic microscopic characteristics of oral leukoplakia include hyperkeratosis of ortho- or parakeratotic type and acanthosis of the epithelium, with various degrees of chronic inflammatory infiltrates in lamina propria 2

Treatment depends on demographic, social, clinical, and histopathologic factors 3
The management of patients with oral leukoplakia is primarily directed towards elimination of possible causative factors 4
If the lesion persists, treatment is recommended in most cases, with no one treatment modality superior to the others 4
Both treated and untreated patients should be scheduled for long-term follow-up, probably life-long, with 6-12 month intervals to detect possible recurrences in an early stage 4
The overall malignant potential of leukoplakia does not exceed 4%, but some authors found that even 16% of leukoplakia with some degree of dysplasia have a potential to transform to carcinoma 2

Leukoplakia is included in the group of lesions with malignant potential, with up to 85% of all precancerous lesions manifested as leukoplakia 2
Understanding the genetic basis of oral cancer development will help design better diagnosis and treatment plans in the cancer clinic 5
Long-term follow-up is essential to detect possible recurrences in an early stage, with intervals of 6-12 months 4