Abstract
One hundred and thirteen biopsies of the palate in people accustomed to smoking cigars, most of them with the burning end of the cigar inside the mouth, have been studied.
Thirty-eight of these showed mild to severe atypical changes in the epithelium. There were 19 lesions showing orthokeratosis and 53 showing hyperorthokeratosis.
The earliest atypical change is seen in the mouths of the ducts of the glands.
There were 3 cases showing microinvasive carcinomas.
Pigmentation is a prominent feature in these cases.
The papules with umbilication could be due to hyperplasia of the mucous glands.
It is suggested that stomatitis nicotina occurring in men and women with the habit of reverse smoking is probably precancerous because of the presence of atypical changes in the epithelium and also the finding of 3 microinvasive carcinomas without any macroscopic evidence.
There is no acceptable explanation why the soft palate escapes getting either stomatitis nicotina lesion or carcinoma in reverse smokers.
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