old case of speckeled leukoplakia -need followup

35 year old male working in up roadways came with the complaint of tooth ache.he was refered to pg clinic due to presence of oral lesion.he was quiet,tense..on asking about his general health ..he gave history of sum neck swelling since 5-6 years.but it was not diagnosed by any docter.he has visited so many docters.underwent all the diagnostic testings like usg,barium meal study for git..but all the reports were normal..he was from a joint family..but he was not going to the social gatherings since 4-5 years.decreased talking nesss..he was lethargic on dental chair..his problem in neck was just causing suffocation..on dental history he was reported 4 years back in the dept for a white lesion on his right bucccal mucosa.an incisional biopsy was done the report was hyperkearatotic area with mild dysplasia.but he was continous with his smoking habit..so in this case we sent him to pshychiatry department for management of his depressive symptoms..and now at present red and white lesion was present on buccal mucosa ..we think about candidal leukoplakia .adviced complete stoppage of habit and topical antifungal and then reguler follow up in this case for early diagnosis of any change in the current lesion.becoz lesion was persisiting on records since more than 4 years.

beauty in this case was our corelation of his neck and stomach tightness problem without any significant pathology with his change in mood and social habits.which were indicating the depression state of his mind..

again stress is also an imporatnt factor for conversion of normal cell into malignant one by its effect on genes.as proposesd by leading cell biologist.