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Smokeless Tobacco K.

Smokeless Tobacco Keratosis

QuestionAnswer
An adult male patient presents with a corrugated, white, diffuse, patch of mucosa in his lower vestibule. There is gum recession adjacent to the white patch. Patient reports that he uses dipping tobacco or "dip" What is the most-likely diagnosis? Smokeless Tobacco Keratosis
• True or false, Smokeless tobacco keratosis is predominantly found in males. True
• Indicate which statements are correct: Statement 1: Smokeless tobacco keratosis can be diagnosed in teens and adults of varying ages. Statement 2: The upper vestibule is the most common location for Smokeless Tobacco Keratosis. Statement 1 is true; statement 2 is false, most commonly found in lower vestibule
• What is another name for Smokeless Tobacco Keratosis? A. Tobacco pouch keratosis B. Snuff pouch C. Snuff Dipper’s Lesion D. Spit Tobacco Keratosis E. All of these are alternate names E. All of these are alternate names
• True or false: Snuff pouch usually takes 1-5 years to develop but may be more rapid in some patients due to an extreme habit of stuffing their vestibule with dipping tobacco/ chewing tobacco. True
What is a differential diagnosis for Smokeless Tobacco Keratosis? Hyperkeratosis, Dysplasia, SCCA, Verrucous hyperplasia, Verrucous carcinoma, Mucosal burn
What age group is usually diagnosed with Smokeless Tobacco Keratosis? Age is variable, but diagnosed as young as in teens
What is a good approach to treating Smokeless Tobacco Keratosis? The patient who has a habit of using smokeless tobacco needs to cease the habit in order for the white patch to return to normal tissue. If the lesion progresses or persists after cessation of the tobacco habit, then a biopsy is necessary.
How is a diagnosis of Smokeless Tobacco Keratosis made? Diagnosis is made by clinical correlation of the tobacco habit along with clinical appearance of changes in the tissue during its use.
• What types of histological features are present in the tissue of a smokeless tobacco user? The tissue is surfaced with hyperkeratotic, acanthotic stratified squamous epithelium with intracellular vacuolization within the keratinocytes. Pointed projections of parakeratin above the superficial epithelial layer (chevron keratinization) are seen.
Created by: Pancakestack