An oral lesion in tobacco-lime users in Maharashtra, India

The habit of chewing tobacco along with lime in the canine-premolar region of the mandibular groove is widespread (28%) in the rural population of Maharashtra, India. Among individuals with this habit, a thick yellowish-white-to-brown lesion was observed at the site of placement of the mixture. Unlike leukoplakia, this lesion could be scraped off. The prevalence of this lesion among 101,761 Maharashtrian villagers was 2.9% which is four times more common than leukoplakia (0.67%). It is surmised that this particular lesion among the tobacco-lime users is a specific entity with consistent histological features. The diagnosis should be made on the basis of history, clinical features, and consistent histological picture.