[Smoking and the skin]

Smoking is the main modifiable cause of disease and death in the developed world. Tobacco consumption is directly linked to cardiovascular disease, chronic bronchitis, and many malignant diseases. Tobacco also has many cutaneous effects, most of which are harmful. Smoking is closely associated with several dermatologic diseases such as psoriasis, pustulosis palmoplantaris, hidrosadenitis suppurativa, and systemic and discoid lupus erythematosus, as well as cancers such as those of the lip, oral cavity, and anogenital region. A more debatable relationship exists with melanoma, squamous cell carcinoma of the skin, basal cell carcinoma, and acne. In contrast, smoking seems to protect against mouth sores, rosacea, labial herpes simplex, pemphigus vulgaris, and dermatitis herpetiformis. In addition to the influence of smoking on dermatologic diseases, tobacco consumption is also directly responsible for certain dermatoses such as nicotine stomatitis, black hairy tongue, periodontal disease, and some types of urticaria and contact dermatitis. Furthermore, we should not forget that smoking has cosmetic repercussions such as yellow fingers and fingernails, changes in tooth color, taste and smell disorders, halitosis and hypersalivation, and early development of facial wrinkles.