Top of This Page Clinical Features Submucous fibrosis typically affects the buccal mucosa, lips, retromolar areas and the soft palate. Occasional involvement of the pharynx and esophagus is seen. Early lesions present as a blanching of the mucosa, imparting a mottled, marble-like appearance. Later lesions demonstrate palpable fibrous bands running vertically in the buccal mucosa and in a circular fashion around the mouth opening or lips. If the tongue is involved, it becomes stiff and has a diminished size.
Salivary flow is diminished and blotchy melanotic mucosal pigmentation is often seen.
More than a fourth of affected persons develop precancerous leukoplakia of one or more oral surfaces. Once present, oral submucous fibrosis does not regress, either spontaneously or with cessation of betel quid chewing. The early cases of oral submucous fibrosis present as chronic inflammatory cell infiltration of subepithelial connective tissues. This otherwise nonspecific infiltrate usually contains a number of eosinophils, cells seldom found in oral inflammation. Older lesions demonstrate a reduced vascularity, reduced numbers of inflammatory cells, and dense bundles and sheets of collagen immediately beneath the epithelium.