Oral cavity
Dermatologic conditions
Smokeless tobacco keratosis

Author: Charu Thakral, M.D. (see Authors page)

Revised: 18 April 2018, last major update March 2013

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

PubMed Search: Smokeless tobacco keratosis

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Cite this page: Thakral, C. Smokeless tobacco keratosis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/oralcavitysmokelesstobacco.html. Accessed January 20th, 2019.
Definition / general
  • Occurs in users of smokeless tobacco (snuff) or tobacco chewers
  • Severity related to length of exposure and tobacco brand
  • Reversible with cessation of use (Arch Pathol Lab Med 2004;128:e17)
Gross description
  • Filmy, gray-white opalescence at areas of contact with tobacco
Microscopic (histologic) description
  • Parakeratosis or hyperorthokeratosis with parakeratin spires ("chevrons"), acanthosis, mild chronic inflammation and PAS+ marked hyalin deposition resembling amyloid
Microscopic (histologic) images

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Hyperorthokeratosis, parakeratosis and acanthosis, diffuse hyalinization of lamina propria, PAS+ hyaline material

Differential diagnosis
  • Hyalinosis cutis et mucosae: deposition begins around vessels, eccrine glands and epithelial-stromal interface, then fills entire dermis of all oral mucosa, tongue, pharynx, larynx and vocal cords