A Retrospective Observational Study on Oral Leukoplakia Patients Adhering to the Mediterranean Diet From Southern Italy.

OBJECTIVES: This retrospective observational study describes demographic, clinical, and pathological variables in a cohort of patients from Southern Italy who adhered to the Mediterranean diet and were diagnosed with oral leukoplakia between 2009 and 2024. The objective was to evaluate the influence of this region-specific dietary pattern on the clinical characteristics of leukoplakia and to determine its malignant transformation (MT) rate. MATERIALS AND METHODS: Data were extracted from the medical records of patients attending the Oral Medicine Section at University of Bari. The collected information included age, sex, lifestyle habits (smoking and alcohol consumption), number of comorbidities, pharmacological treatments, lesion site and clinical appearance, histological features, symptoms, and human papillomavirus infection. Descriptive and analytical statistical analyses were performed. RESULTS: A total of 104 patients were included, with a mean follow-up of 4.1 years. Both sexes were almost equally affected, with a mean age of 56 years. A low prevalence of smokers (30.7%) and alcohol users (25%) was observed. Among smokers, leukoplakias were generally homogeneous, whereas among alcohol users, the lesions were predominantly nonhomogeneous. Only a small proportion of lesions (22%) exhibited dysplasia. The tongue was the most frequently affected site (39%) and demonstrated the highest risk of MT. The overall MT rate was 1.9%. CONCLUSIONS: The results of our study may have been positively influenced by the dietary lifestyle of our patients; however, further multicentric studies are needed to strengthen the scientific evidence in this regard by comparing the dietary habits of patients from different geographic areas. CLINICAL RELEVANCE: Although numerous studies have examined patient cohorts with OL across various areas of the world, few have focused on populations from the Mediterranean area, and none have included southern Italy. Therefore, our study represents the first documented cohort of patients with OL adhering to the Mediterranean diet in Southern Italy.