[Oral submucous fibrosis in a 31-year-old Indian women: first case report from Germany]

Oral submucous fibrosis (OSF) is a chronic disease characterized by subepithelial collagen deposition with formation of bands involving the oral cavity and adjacent structures. Oral submucous fibrosis is a precancerous condition. It is caused by chewing of betel quid (Areca catechu L., Piper betle, lime and tobacco) and ready-made products like pan masala and gutka which also contain areca nut. These products are available all over South Asia. The hallmark of OSF is extremely restricted mouth opening.

A 31-year-old Indian woman who has lived in Germany since 1997 presented herself because of limitation of mouth opening. She reported that she has chewed pan masala and gutka since she was 17 years of age. History, clinical and histological findings clearly pointed to the diagnosis of OSF.

Conservative as well as surgical interventions for OSF have not resulted in adequate long-term results. Since OSF may occur in children and young adults, the primary aim should be to avoid progression of the disease, initially by physiotherapy. Surgical interventions should not be applied at an early stage of the disease because recurrences and further surgical interventions are often necessary. Due to the increasing numbers of migrants from South Asia more cases of OSF will probably also be observed in Germany, where areca nut-containing products are also available.