An 84-year-old female patient was referred to the Stomatology and Oral Surgery Department of the University of Cartagena for presenting oral cavity discomfort.
Clinical examination reveals multiple plaques, spots on surface appearance variations consistency irregularly distributed throughout the hard palate compromising the anterior and middle thirds, on the left and right sides; with an asymptomatic white-to-gray appearance cm ranging from mild
The patient reported smoking cessation 40 years ago and reported smoking 5 cigarettes a day.
In this patient a clinical impression of homogeneous leukoplakia was given and, to make the definitive diagnosis, an incisional biopsy was programmed.
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Procedure
After obtaining informed consent, a bilateral nasopalatine and anterior palatal anesthetic technique was applied, using lidocaine with 2% epinephrine. A blunt incision was made, followed by a soft palate tissue dissection on the side of the scalpel with a 15-point sterile edge suture.
The patient was verbally and in writing.
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The patient returned to post-surgical control after 7 days, with good condition and healing.
Histopathological report indicates palatal mucosa with marked keratosis without "dysplasia".
Monthly controls are carried out observing the almost total disappearance of the pathology; however the patient reports that she has started the reversed smoking habit again and, in the last control, new appearance of white plaques is observed.
We observed a strong association between inverted smoking and the appearance of premalignant lesions.
