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Nicotine addiction and comorbidity with alcohol abuse and mental illness

PVL has one or more areas of homogeneous leukoplakia, which grows slowly and persistently, and tends to become multifocal with exophytic, verrucous, or erythematous areas.22 After a long period, commonly six years, the evolution to carcinoma occurs.23 Areas that are erythematous, verrucous or have papillary surface are characteristic of malignant transformation, and so these areas should have a histopathological confirmation (Fig