Multidisciplinary Approach for Treatment of Potentially Malignant Disorder in a Chronic Smoker

Abstract

A 61-year-old male patient with hypertension, who has been a smoker for 40 years, was referred to our clinic for evaluation of a lesion on the soft palate. An intraoral examination revealed an erosive lesion on the soft palate, measuring 2.0 cm, clinically diagnosed as erythroplakia. A biopsy and histopathological examination revealed a moderate epithelial dysplasia. The patient was referred for a multidisciplinary treatment to quit smoking, involving medical and psychological approaches. The treatment involved transdermal nicotine patches for 7 days, with a dose reduction scheme, and bupropion chloral hydrate administration for 60 days. The patient was submitted to psychological monitoring for emotional support and investigation of psychological factors associated with tobacco use. After 14 days of treatment initiation, the patient completely stopped using cigarettes. After a 10-month follow-up, physical examination revealed a total regression of the oral lesion. This case denotes the importance of a multidisciplinary approach for tobacco-induced oral lesions.