What is the next step when leukoplakia is observed in a patient?

When leukoplakia is observed in a patient, the next step is to perform a biopsy of the lesion. Leukoplakia appears as a white patch on the mucosal surfaces and can be potentially precancerous; therefore, it is essential to determine the nature of the lesion through histopathological examination. A biopsy allows for the assessment of cellular changes and helps rule out any malignant transformation.

The concern with leukoplakia is that while some cases may be benign and related to irritation or other non-malignant causes, others may indicate dysplasia or even squamous cell carcinoma. By conducting a biopsy, clinicians can gain valuable insight into the condition and decide on the appropriate management based on the results.

The other options may not address the immediate need for diagnosis that a biopsy fulfills. Immediate excision may be considered for certain lesions, but it is typically not the first step without confirming the pathology. Antifungal treatment is inappropriate unless there’s clear evidence of a fungal infection, which is not commonly indicated in leukoplakia cases. Referring to a specialist can be part of the management plan after evaluation, but prior to that step, obtaining a definitive diagnosis through biopsy is crucial.