Homogeneous leukoplakia appears uniformly white with a smooth or corrugated surface and has a low risk of malignant transformation. Nonhomogeneous leukoplakias appear white and red and have a much higher risk of malignant malformation. These leukoplakias can exist with blunt projections or slightly raised nodules. A rare lesion called erythoplakia is a whitish lesion that includes bright red velvety plaques with an irregular outline. Spit tobacco induced oral lesions can occur anywhere in the mouth.
Lesions can also occur on the cheek, tongue, lips, floor of the mouth and palate.
Typically, lesions are identified in the location where spit tobacco is placed. According to a U.S. Air Force study, if the area of the lesion is not exposed to spit tobacco for an extended period, the lesion will usually dissipate within about 6 weeks. Persistent lesions require biopsies for verification of malignancy. Lesions that are distinguished as cancerous necessitate a combination of therapy such as surgery, radiation therapy and chemotherapy. The size of the tumor dictates the treatment rendered to patients.