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Leukokeratosis nicotina palati
Abstract
Leukokeratosis nicotina palati or stomatitis nicotina is a benign disorder of the palatal mucosa. It is more common in males who are important pipe smokers. The smoke of the tobacco causes it, and its prevalence is correlated with the amount of pipe tobacco that is smoked. The clinical features are characteristic, and results in a diffuse hiperkeratosis of the palatal epithelium and inflammation of the salivary glands. The lessions are principally located on the hard palate and consist of multiple white papules, with an ocassional central red depression, giving a cobblestone appearance. The diagnosis is easy, based on the antecedent of pipe smoking and the characteristic clinical features. A biosy is useful to rule out other white oral lessions. There is no risk of malignant transformation. Treatment is to stop consumption of tobacco, after which the lessions tend to regress. We report a case of leukokeratosis nicotina palati, with a severe picture, affecting a male who was an important pipe smoker for more than 45 years; after cessation of tobacco use, the lessions slowly decreased in a 52-month follow-up.
Dermatology departments are currently seeing an increase in the number of cases of oral diseases. Of note among the range of lesions covered by this broad area of knowledge is oral leukoplakia—the most common precancerous lesion and the most problematic in terms of both diagnosis and therapeutic management.In addition to defining leukoplakia, this review also establishes a differential diagnosis with the other most important oral diseases and analyzes the different clinical, histologic, and molecular features that can provide an indication of the risk of malignant transformation. Finally, a therapeutic algorithm is presented to help us optimize clinical management of the disease.
Dermatology departments are currently seeing an increase in the number of cases of oral diseases. Of note among the range of lesions covered by this broad area of knowledge is oral leukoplakia-the most common precancerous lesion and the most problematic in terms of both diagnosis and therapeutic management. In addition to defining leukoplakia, this review also establishes a differential diagnosis with the other most important oral diseases and analyzes the different clinical, histologic, and molecular features that can provide an indication of the risk of malignant transformation. Finally, a therapeutic algorithm is presented to help us optimize clinical management of the disease.
We report a new case of stomatitia nicotina affecting a 65 years-old male, pipe smoker, who was reffered to the dermatology service because the presence of several painless white lessions on his palate. Histologycal observations showed that the lessions were papulated and related within the end of the minor salivary glands. Nowadays, it is commonly acepted that the typical stomatitis nicotina presents with white oral lessions that behave clinically differently than leucoplasy with diskeratosis. We also agree that smoker's Keratosis should never be considerated as a precancerous entity.
ABSTRACT Clinical inspection was made of the palatal mucosa of 3,819 patients at the Royal Dental College, Copenhagen. Any occurrence of leukokeratosis nicotina palati (LNP) was recorded, as were the patients' general data and information on their smoking habits. LNP was most prevalent in 30- to 39-year-olds. Prevalence was considerably greater among males than females, even when comparing groups with the same smoking habits. LNP was found in connection with all forms of smoking. In male patients, approx. 30 % of pipe smokers had LNP compared with approx. 7 % of other smokers. The greatest single factor of importance to the prevalence of LNP, among those who smoked a pipe only, was the level of consumption. The smoking period was of no particular significance. Individual susceptibility is illustrated by the fact that even among pipe smokers with a relatively high consumption, 40 % did not exhibit LNP.
A survey related to the detection of precancerous lesions of the oral cavity has been done in Cuba for the first time. The sample comprised 749 randomly selected workers from Havana City Province, taking into account the census records of the Cuban population up to 1979. Prevalence of lesions and their relation to age, sex and predisposing factors, such as smoking, alcohol habits and mechanical trauma were studied. 4.4% of leukoplakia and preleukoplakia considered together and 2.1% leukoplakia alone, and two cases of oral lichen planus and leukokeratosis nicotina palati (0.1% of each) were found. The former lesions were more frequently encountered in people above 50 years old, specially in males and specifically among those who had smoked for more than 10 years. Sites of location most frequently encountered were the buccal mucosa and the labial commissures.
The aim of this study was to determine the prevalence of oral leukoplakia and other oral white lesions in an urban population of non-referred patients to a department of oral surgery in the city of Berlin.
A total of 1000 patients over the age of 16 were evaluated for oral leukoplakia and other oral white lesions. Age, sex, and smoking as well as alcohol habits were recorded.
Of 506 men (50.6%) and 494 women (49.4%), 0.9% showed oral leukoplakia. Men were more frequently affected (1.6%) than women (0.2%). Patients of older age groups were more frequently affected than younger patients. Other white oral lesions were recorded such as leukoedema (8.3%), smoker's palate (0.1%), frictional white lesions (2.6%) and lichen planus (0.6%) with equal distribution between men and women.
The prevalence of oral leukoplakia in this limited group of urban patients was low, however comparable to that of other neighbouring west European countries. Association with tobacco and alcohol consumption was demonstrated as in most other studies.
