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There are several conditions that we need to consider and rule out when diagnosing specific oral abnormalities commonly associated with smokeless tobacco use: Smokeless Tobacco Keratosis: Frictional keratosis Leukoplakia Squamous cell carcinoma Leukoplakia: Leukoedema Linea alba Morsicatio buccarum/linguarum Squamous cell carcinoma Erythroplakia: Mucositis Candidiasis Psoriasis Vascular lesions Squamous cell carcinoma Verrucous Carcinoma: Proliferative verrucous leukoplakia Verruca vulgaris Squamous papilloma Squamous Cell Carcinoma: Erythroleukoplakia Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) Oral manifestation of deep fungal infection What to expect with Pathologic Manifestations of Smokeless Tobacco The outlook for smokeless tobacco keratosis, a condition often found in people who use chewing tobacco, is generally good but depends largely on the patient