5-aminolevulinic acid photodynamic therapy for extensive oral leukoplakia with concomitant oral submucous fibrosis: A case report

Oral leukoplakia (OLK) and oral submucous fibrosis (OSF) are oral potentially malignant disorders with high recurrence and malignant transformation rates. Notably, OLK with concomitant OSF exhibits significantly higher malignant transformation rate than OLK or OSF alone.Photodynamic therapy (PDT) is a minimally invasive treatment modality that effectively targets oral potentially malignant disorders, with the advantages of being repeatable and leaving no scarring. We report the case of a 42-year-old man with OLK-OSF almost involving the entire right buccal mucosa, who underwent six sessions of topical 5-aminolevulinic acid-mediated PDT. PDT successfully eradicated whitish plaques and improved mouth opening without any adverse effects. Although PDT failed to completely reverse the pathological changes, grading of epithelial dysplasia did not progress and clinical recurrence was not found during the 10-month follow-up. In conclusion, topical 5-aminolevulinic acid-mediated PDT appears safe and has excellent clinical efficacy against OLK-OSF, but long-term follow-up is necessary.