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CASE REPORT article

Front. Oncol.
Sec. Head and Neck Cancer
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1473889

Eradication of proliferative verrucous leukoplakia with toll-like receptor 7 agonist (topical imiquimod): A case report

Provisionally accepted
Melanie Townsend Melanie Townsend 1Alexandra E. Kejner Alexandra E. Kejner 2Farzad Nourollah-Zadeh Farzad Nourollah-Zadeh 2Fabio A. Rizzante Fabio A. Rizzante 2Tina R. Woods Tina R. Woods 2Sonali Rathore Sonali Rathore 2Douglas Alterman Douglas Alterman 2Sorin Teich Sorin Teich 2William G. Albergotti William G. Albergotti 2Jason G. Newman Jason G. Newman 2Angela Yoon Angela Yoon 2*
  • 1 University of Louisville, Louisville, Colorado, United States
  • 2 Medical University of South Carolina, Charleston, United States

The final, formatted version of the article will be published soon.

    Proliferative verrucous leukoplakia (PVL) is an aggressive and distinct type of oral precancerous lesion characterized by warty surfaced white plaque diffusely involving oral mucosa. Surgical excision is the treatment of choice. However, PVL has persistent and recurrent growth patterns, requiring multiple surgical procedures. Surgical intervention is especially challenging if PVL extends between teeth limiting access. These interproximally located lesions have a high propensity to undergo malignant transformation. We report a case of a 53-year-old man with recurrent PVL diffusely covering the maxillary and mandibular gingiva. Despite complete surgical excisions, PVL recurred, and a focal area in the interproximal mandibular gingiva progressed to invasive squamous cell carcinoma requiring marginal resection. The remaining PVL areas were treated with topical imiquimod (toll-like receptor 7 agonist) for six months, resulting in complete clinical and histological resolution. Topical agents can cover a larger surface area and penetrate in between interproximal areas. Importantly, it allows for maximal local exposure with minimal systemic toxicity, essential for long-term treatment and prophylactic use of the agent to prevent relapse.

    Keywords: Proliferative verrucous leukoplakia, Topical imiquimod, Toll-like receptor 7 agonist, Oral neoplasm, Treatment

    Received: 06 Aug 2024; Accepted: 29 Oct 2024.

    Copyright: © 2024 Townsend, Kejner, Nourollah-Zadeh, Rizzante, Woods, Rathore, Alterman, Teich, Albergotti, Newman and Yoon. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Angela Yoon, Medical University of South Carolina, Charleston, United States

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