Verrucous leukoplakia of the red border caused by the use of IQOS heated tobacco product (a case report)

Abstract

The aim. To analyze possibility of development and describe the clinical case of the red border verrucous leukoplakia caused by the use of IQOS heated tobacco product and HEETS sticks and propose personalized clinical, diagnostic and therapeutic algorithm of a patient management. Materials and methods. Based on own observation, this article describes a clinical case of verrucous leukoplakia of the red border arising in a patient who used IQOS heated tobacco product and HEETS sticks. Clinical, laboratory, instrumental examination and treatment were performed on the basis of the Department of Dermatovenereology and Cosmetology with the course of Dermatovenereology and Aesthetic Medicine of the Postgraduate Education Faculty of Zaporizhzhia State Medical University. Results . The plaque-type verrucous leukoplakia of the red border was diagnosed based on clinical examination of the patient and diagnosis verification by means of laboratory examination and dermatoscopy. Considering the possible traumatic lesion, a high probability of the disease recurrence, patient’s refusal of surgical treatment methods, the topical therapy for affected area with the use of combined drug containing glucocorticosteroid, antibacterial and antimycotic components was prescribed for 1 month followed by long-term therapy using 1 % pimecrolimus cream. Conclusions. Based on the literature analysis, it was found out that IQOS heated tobacco product and HEETS sticks can promote the development of such manifestations of oxidative stress and endothelial dysfunction as inflammation, infection, fibrosis, oncologic pathology and become one of initiating agents for the occurrence of red border verrucous leukoplakia. The use of topical glucocorticosteroids combined with topical inhibitors of calcineurin can be proposed as an alternative to surgical methods of treatment for leukoplakia and it requires more detailed study.