title: [Oral and extraoral disease due to betel nut chewing].
abstract: OBJECTIVE
  Betel chewing is common in India and southeast Asia. It shows mild psychostimulatory effects but with prolonged use there is a risk of oral and extraoral disease. Surprisingly, betel nut associated disorders are rarely discussed in the dermatological literature.
  
  
  METHODS
  A review about betel nut associated disease is given based on a literature review and our own experiences.
  
  
  RESULTS
  Both benign and malignant diseases can be induced by betel nut chewing. Betel causes reddish discoloration of teeth, periodontitis and buccal mucositis. Submucous fibrosis is a precancerous disease that may eventually develop into oral squamous cell cancer (OSCC). Among malignant diseases induced by betel quid, OSCC is the most important but esophageal cancer and hepatocellular cancer can also be observed. The available treatments are of limited value.
  
  
  CONCLUSIONS
  Betel nut chewing has its own morbidity and mortality due to the induction of benign and malignant diseases. There is a lack of controlled trials although both betel nut chewing and the associated diseases are common.
authors.affiliation: Hautklinik, Krankenhaus Dresden-Friedrichstadt, Germany. Wollina-Uw@khdf.de
authors.forename: U
authors.initials: U
authors.lastname: Wollina
authors.forename: S
authors.initials: S
authors.lastname: Verma
authors.forename: D
authors.initials: D
authors.lastname: Parikh
authors.forename: A
authors.initials: A
authors.lastname: Parikh
mesh_terms: D001114:Areca / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000139:chemically induced* / Q000175:diagnosis; D002294:Carcinoma, Squamous Cell / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D008113:Liver Neoplasms / Q000139:chemically induced* / Q000175:diagnosis; D009059:Mouth Diseases / Q000139:chemically induced* / Q000175:diagnosis; D009062:Mouth Neoplasms / Q000139:chemically induced* / Q000175:diagnosis; D012307:Risk Factors