Nicotine stomatitis
DESCRIPTION: The classic form of this disease occurs in the palate of those who smoke pipes and cigars. The typical appearance is that of numerous, slightly raised, white, papular lesions of the posterior hard palate and soft palate. The central portion of the papules are red and represent inflamed orifices of minor salivary gland ducts. In more severe cases, the palatal mucosa is white and criss-crossed by fissures. There are no symptoms and lesions may be discovered in a routine oral examination.
ETIOLOGY: This lesion is caused by smoking, chiefly pipe and cigar smoking. A report of thermally induced “nicotine” stomatitis in a woman who drank scalding hot tea and soup suggests heat rather than tobacco products are responsible for this condition.
TREATMENT: This disease usually disappears after discontinuance of the causative factor.
DIFFERENTIAL DIAGNOSIS: The clinical appearance of nicotine stomatitis coupled with a history of smoking is virtually diagnostic. Biopsy is seldom necessary.
