American Medical Association Family Medical Guide - American Medical Association [98]
Gum damage from smokeless tobacco Smokeless tobacco can cause changes in the mouth and gums such as discolored teeth, tooth abrasion, receding gums (exposing the roots of the teeth), and loss of supporting bone and gum tissue. The damage may be permanent. Using smokeless tobacco can also lead to other mouth conditions, such as leukoplakia (see page 744) or oral cancer (see page 747).
Oral cancer
Oral cancer (see page 747) is usually caused by smoking cigarettes or cigars or by using smokeless tobacco. Cancer on the lips or just inside the mouth (left, squamous cell carcinoma) can also be caused by sun exposure. Signs include a painless or painful discolored area or lump anywhere in the mouth, including on the tongue, that does not heal within a couple of weeks.
Leukoplakia
Leukoplakia (see page 744) is a disorder of the mucous membranes of the mouth in which raised, white patches develop in the mouth or on the tongue. The condition results from chronic irritation caused by smoking, using smokeless tobacco, poor dental hygiene, poorly fitting dental appliances, or a jagged tooth. If left untreated, leukoplakia can lead to oral cancer (see page 747).
Nail and Scalp Disorders
Paronychia
In paronychia (see page 1077), the cuticles and nail fold become swollen, inflamed, and painful as a result of a bacterial or fungal infection. Abscesses called whitlows make the base of the nail swell. In some cases, the nails are also thick and powdery.
Psoriasis of the nails Some skin disorders can also affect the nails. When psoriasis (see page 1064) affects the nails, they become pitted, rough, and abnormally thick.
Clubbed nails
Clubbed, or spoon-shaped, fingernails often occur in people with lung or heart disease and occasionally in people with inflammatory bowel disease (see page 1078). The tips of the fingers are bulbous and rounded. (Fingernails and fingertips that have been rounded since birth usually do not result from an underlying disorder.)
Bald patches on the scalp Hair loss that occurs in round patches on the scalp may result from a condition called alopecia areata (see page 1076), which can be triggered by stress.
Eye Disorders
Jaundice
Jaundice (see page 785), a condition resulting from too much of a pigment called bilirubin in the blood, causes the skin and the whites of the eyes (above) to turn yellow. Jaundice usually results from liver disorders.
Corneal ulcer
A corneal ulcer (see page 1037) is a break or open sore in the outer layer of the cornea (the clear, protective covering at the front of the eye). An ulcer on the cornea may make the white of the eye turn pink or red. In some cases, an ulcer can appear as a whitish patch that may impair vision.
Cataract
A cataract (see page 1041) is a clouding of the normally clear lens of the eye. An advanced, or mature, cataract resembles a gray or misty-looking circle within the normally black pupil. Cataracts can reduce vision.
Conjunctivitis
In conjunctivitis (see page 1038), a membrane called the conjunctiva (the membrane that lines the eye) becomes painful, red, and inflamed. The eye may feel gritty and itchy and have a sticky discharge. In some cases, the eye may be sensitive to light.
Ectropion
In ectropion (see page 1035), the lower eyelid hangs away from the eyeball, giving the appearance that the eyelashes are turned outward. The inner surface of the eyelid is exposed and the lining and the eyeball become sore and dry. A person with ectropion has excess tearing because the tears cannot drain properly.
Pterygium
A pterygium is a thickening of the conjunctiva (the membrane that lines the eye), causing it to grow and cover part of the cornea (the clear, protective covering at the front of the eye), usually in a winglike or fanlike pattern. Pterygiums usually appear on the inner corner of the eye and may grow large enough to interfere with sight. In