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Much has been written on leukoplakia buccalis, but so far no conclusion has been reached in regard to its cause.
As far as its connection with syphilis is concerned, medical writers have expressed opinions varying from a consideration of the association of the two conditions as merely accidental to a consideration of syphilis as an indirect cause or a direct one. The latter view is held in spite of the fact that antisyphilitic therapy has no effect on leukoplakia, that the percentage of syphilitic patients showing leukoplakia is small and that leukoplakia is rare in the Negro race, in which syphilis is widespread.
As for tobacco, with the exception of a few discordant voices, the opinion of authors is overwhelmingly in favor of considering smoking a direct cause of leukoplakia buccalis, in spite of the facts that leukoplakia is found in nonsmokers and in parts of the body other than
Ronchese F. LEUKOPLAKIA AND TOBACCO. Arch Derm Syphilol. 1937;36(6):1222–1224. doi:10.1001/archderm.1937.01480060095017
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