Snuff lesion (smokeless tobacco lesion)

DESCRIPTION:  The lesion develops on the mucosa where smokeless tobacco is held.  The usual appearance is white, wrinkled or corrugated mucosa. Gingival recession is a  common manifestation with cervical erosion of teeth a less frequent finding. Symptoms are uncommon.

ETIOLOGY:    Prolonged  use  of  smokeless  tobacco  produces such as chewing tobacco or snuff.

TREATMENT:  Biopsy should be done to rule out dysplasia, otherwise no treatment is necessary.

PROGNOSIS:  Verrucous and squamous carcinomas arise in smokeless tobacco lesions more than chance alone can explain. One article noted almost a 50-fold increased risk of cancers of the gingival  and  buccal  mucosa in females who were chronic users. The duration necessary   to   induce   dysplastic   or   malignant   change   is unknown but appears to be at least 20 years.

DIFFERENTIAL  DIAGNOSIS:   The clinical appearance of the  lesion  plus  a  history  of  using  smokeless  tobacco establishes the diagnosis.

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