White Plaque on the Tongue
A 40-year-old man presented to the outpatient clinic with 4-month history of a painless, white lesion on the tongue. He reported a long history of smokeless tobacco use and moderate alcohol use. Examination revealed a well-defined, firm, adherent, slightly raised white plaque on the left lateral surface of the tongue. Tobacco stains were present on the teeth. Testing for human immunodeficiency virus was negative. A biopsy of the lesion was performed, and a diagnosis of leukoplakia was made. Leukoplakia is a premalignant condition associated with the development of oral squamous-cell carcinoma. Risk factors include smoking or chewing of tobacco, consumption of alcohol, and chewing of betel nuts. The patient underwent laser ablation of the lesion and was counseled about the risks of tobacco and alcohol use. At follow-up 6 months later, he was doing well and had had no recurrence of the lesion.