How to Approach A Patient Who Refuses the Recommended Mammoplasty Technique

Objective: To evaluate the changes in the number of Langerhans Cells (LC) observed in the epithelium of smokeless tobacco (SLT-induced) lesions. Methods: Microscopic sections from biopsies carried out in the buccal mucosa of twenty patients, who were chronic users of smokeless tobacco (SLT), were utilized. For the control group, twenty non-SLT users of SLT with normal mucosa were selected. The sections were studied with routine coloring and were immunostained for S-100, CD1a, Ki-67 and p63. These data were statistically analyzed by the Student’s t-test to investigate the differences in the expression of immune markers in ormal mucosa and in SLT-induced leukoplakia lesions. Results: Th re was a significant differenc in the immunolabeling of all markers between normal m cosa and SLT-induced lesions (p<0.001). The leukoplakia lesions in chro i SLT us rs demonstrated a significant increase in the numb r of Langerhans cells and in the absence of epithelial dysplasia. Conclusion: The increase in the n mber of these cells represents t initial stage of leukoplakia. Key w rds: Smokeless tobacco, leukoplakic lesions, cancer, langerhans cells, chewing tobacco.