Reversibility of snuff dippers' lesion in Swedish moist snuff users: a clinical and histologic follow-up study.
The purpose of this study was to assess possible reversibility of oral mucosal changes, associated with the use of Swedish moist snuff, after change of habit. Biopsies from a total material of 252 regular snuff users, 184 using loose snuff and 68 using portion-bag packed snuff, were screened microscopically to identify histopathologic epithelial changes in addition to, or differing from, those generally seen as a result of snuff use. The main basis for selection of these variables were the criteria of epithelial dysplasia as defined by WHO and the eight histologic features, which have been reported to be the most important discriminators to separate cases with leukoplakia that subsequently developed carcinoma, from those that did not. Twenty-nine subjects, 3 showing Degree 2 lesions, 21 Degree 3 lesions and 5 Degree 4 lesions, all of them loose snuff users were identified. All the 29 users were re-examined clinically and histologically after 3-6 months. The rebiopsy was always secured from the same mucosal area as the original biopsy. At follow-up, 20 subjects had either stopped their snuff habit or changed to portion-bags and changed placement of the quid. All of them showed a healthy mucosa at the previous biopsy site and normal tissue in the histologic examination of the rebiopsies. Seven subjects had changed to portion-bags and variably reduced their daily exposure to snuff. At follow-up they presented with less pronounced clinical changes and the rebiopsies showed evidence of reduced epithelial changes. One major conclusion from this study is that tissue changes, clinically as well as histologically, are reversible following cessation of snuff habit.(ABSTRACT TRUNCATED AT 250 WORDS)
Larsson
A
A
Department of Oral Pathology, Lund University, Malmö, Sweden.
Axéll
T
T
Andersson
G
G
D000328:Adult; D002448:Cell Adhesion; D002452:Cell Count; D003238:Connective Tissue / Q000473:pathology; D004804:Eosinophils / Q000473:pathology; D004848:Epithelium / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008938:Mitosis; D009059:Mouth Diseases / Q000473:pathology* / Q000503:physiopathology; D009061:Mouth Mucosa / Q000473:pathology; D010947:Plants, Toxic; D013997:Time Factors; D014030:Tobacco, Smokeless / Q000009:adverse effects; D014945:Wound Healing