Oral changes associated with kolanut use: a report of 2 cases

Introduction: Contact stomatitis (CS) is an inflammatory reaction of the oral mucosa induced by contact with an irritant, such as menthol and cinnamon compounds. We are reporting 2 cases of CS related to the use of kolanut, a caffeine-containing nut of evergreen trees.

Case description: Case 1 was a 22-year-old man with history of chewing kolanut for the past 10 years; he presented with a grayish-white, velvety, leukoplakia-like plaque with ill-defined borders in the mandibular anterior facial vestibule and extending to the lower labial mucosa. The patient had never consumed tobacco products or alcohol before. Histopathologic analysis revealed hyperparakeratosis with otherwise normal epithelium. The patient continued kolanut consumption with persistent oral changes. Case 2 was a 29-year-old man with history of chewing kolanut for the past 2 years; he presented with extensive, diffuse, white, leukoplakia-like plaques on the anterior maxillary and all mandibular gingiva and vestibule, with epithelial desquamation and erosive patches. The patient reported smoking 30 cigarettes per day for the last 11 year. Following cessation of kolanut use, the leukoplakia-like lesion resolved with persistent erythema.

Conclusions: This is the first report of histopathologic characterization of CS associated with the use of kolanut, which is believed to be reactive in nature with unknown premalignant potential.