SNUFF POUCH (SMOKELESS TOBACCO KERATOSIS)

Question 1

CONCEPT

Answer 1

FORM OF HYPERKERATOSIS CAUSED BY NITROSAMINES AND HYDROCARBONS CONTAINED IN THE TOBACCO

Question 2

CLINICAL RESULTS

Answer 2

• LONG-TERM EXPOSURE TO SMOKELESS TOBACCO INCLUDE THE DEVELOPMENT OF ORAL MUCOSAL WHITE PATCHES WITH A SLIGHTLY INCREASED MALIGNANT POTENTIAL, DEPENDENCE, ALTERATIONS OF TASTE, ACCELERATION OF PERIODONTAL DISEASE AND SIGNIFICANT AMOUNTS OF DENTAL ABRASION
• APPEARS AS WHITE OR GRAY PLAQUE INVOLVING THE MUCOSA IN DIRECT CONTACT WITH SNUFF OR CHEWING TOBACCO. MUCOSA DEVELOPS A GRANULAR TO WRINKLED APPEARANCE

Question 3

ORALLY CLINICALLY

Answer 3

MUCOBUCCAL FOLD OF THE MANDIBLE IN THE INCISOR OR THE MOLAR REGION

Question 4

SYMPTOMES

Answer 4

NO: INDURATION, ULCERATION, PAIN

Question 5

MALIGNANT TRANSFORMATION

Answer 5

LOW (SQUAMOUS CELL CARCINOMA RELATED TO SMOKELESS TOBACCO USE TYPICALLY DEVELOPS AFTER A LATENCY PERIOD OF SEVERAL DECADES)

Question 6

DIAGNOSIS

Answer 6

BIOPSY: FOR SEVERE OR ATYPICAL LESIONS (INTENSE WHITENESS, GRANULAR OR VERRUCIFORM CLINCAL APPEARANCE ULCERTION, MASS FORMATION, INDURATION, HEMORRHAGE)

Question 7

TREATMENT

Answer 7

• HABIT CESSATION LEADS NORMAL MUCOSAL APPEARANCE (2 WEEKS)
• 98% SMOKELESS TOBACCO KERATOSES NOT INTENSELY WHITE
• LESION REMAINS AFTER 6 WEEKS WITHOUT SMOKELESS TOBACCO CONTACT SHOULD BE CONSIDERED A TRUE LEUKOPLAKIA (BIOPSY AND MANAGED ACCORDINGLY)