Oral Lesions Induced by Chronic Khat Use Consist Essentially of Thickened Hyperkeratinized Epithelium
Table 1
Standardized criteria used to identify and to take biopsy of khat induced oral lesions.
Parameter
Criteria
Site of lesion
Normally limited to buccal mucosa where khat bolus is placed during chewing, around and especially below (inferior to) the linea alba. Most adjacent areas of buccal mucosa remain relatively normal and clearly distinguishable from oral white lesion. Could involve the lateral border of tongue and the gum. Usually does not involve the palate.
Texture
Lesion could be smooth, wrinkled, rough, or plaque-like.
Colour
Mostly white, but could be grey, black, or brown. A mixture of any of these colours could occur. Though rare, it could have red areas within it.
Side of the lesion
On the side identified as the chewing side.
Biopsy taking
Only from buccal mucosa. Biopsy an oval tissue of not more than 1 cm long and not less than 0.3 mm width. Preferably below the linea alba, or choose the centre of the lesion on buccal mucosa.
