Leukoplakia of the vocal folds is commonly found in association with hoarseness in smokers
Direct laryngoscopy with biopsy is advised in almost all cases
Histologic examination usually demonstrates mild, moderate, or severe dysplasia
In some cases, invasive squamous cell carcinoma is present in the initial biopsy specimen
Cessation of smoking may reverse or stabilize mild or moderate dysplasia
Some patients—estimated to be less than 5% of those with mild dysplasia and about 35–60% of those with severe dysplasia—will subsequently develop squamous cell carcinoma

Treatment

options include proton-pump inhibitor therapy, close follow-up with laryngovideostroboscopy, serial resection, and external beam radiation therapy