Tobacco induced Leukoplakia with Candidiasis :
Today a male patient old 58 years ,visited the hospital with a history of pain in one of this teeth. The patient was completely unaware of a lesion in his right buccal area near 34 and 35 region in his mouth. When it was noticed in his mouth it showed a completely homogeneous membranous mass, which was not as wrinkled as it was in one of my earlier cases of Tobacco Pouch Keratosis . The lesion was not ulcerated nor it had any significant pigmentation in it. In the periphery there was a grayish tint which bordered the sections of the lesion . From the history of habits of the patient it was found that the patient was a chronic smokeless tobacco user and he used to keep the tobacco in the same area that is affected .He has been using tobacco since last 35 years .the patient had no sign of pain or sensation in the affected area and was pretty reluctant to have a follow up. The lesion was smooth grayish in appearance and the surface was easily scraped off with the use of slight pressure leaving a hyper-keratic patch below it. The superficial surface was a pseudo-membrane which resembled a similar characteristic as that in case of Pseudo-membranous Candidiasis and the exposed lesion below resembled the grayish white patch like that in Leukoplakia . This was a classical case in which the patient has leukoplakia with a secondary candidal growth over it .
