Smokers may develop a change on the hard palate that may be called smoker's patch, smoker's palate, smoker's keratosis or stomatitis nicotina palati. It probably is due to a combination of mucosal burn and irritation.


Patient at risk:

(1) heavy cigarette or cigar smoker

(2) pipe smoker


Clinical findings:

(1) erythema or white cobblestoning (whitish mucosa with fissuring) that involves an area of the hard palate exposed to jets of tobacco smoke

(2) orifices to minor salivary gland ducts are inflamed, with swelling and erythema

(3) complete reversal on discontinuation of the smoking habit


A biopsy may show chronic inflammation with squamous metaplasia and hyperkeratosis. Dyskeratosis is absent and the lesion is not considered precancerous.


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