How to Know if You Are Listed as a Tobacco User

Lung Republic of india. 2013 Jan-Mar; 30(1): 79–81.

Tell-tale signs of a chronic smoker

Vivek Chauhan

Department of Medicine, Dr. Rajendra Prasad Government Medical College, Tanda, Kangra, Himachal Pradesh, India. E-mail: moc.oohay@almihskevivrd

Rajesh Sharma

Department of Medicine, Dr. Rajendra Prasad Government Medical College, Tanda, Kangra, Himachal Pradesh, India. Email: moc.oohay@almihskevivrd

Suman Thakur

¹ Section of Microbiology, Dr. Rajendra Prasad Regime Medical College, Tanda, Kangra, Himachal Pradesh, Republic of india

Sir,

Tobacco smoking is quite common in all sections of Indian society and two master forms of tobacco are cigarette and biri. Biri is formed by stuffing tobacco within tendu leaves and tied with a thread at i stop. Biri has no filter, and to keep it burning ane has to take an average of 28 puffs every bit opposed to 10 in a cigarette. Heavy smokers and chronic smokers have many reliable clinical signs that point towards their addiction of smoking, and tin can be handy in suspecting and diagnosing chronic obstructive airways disease (COAD) at an early stage, even if the patient denies smoking. In this work, we nowadays a list with clarification of various clinical signs of smokers. Some of the signs (e.one thousand., Chingari sign) may be more specific for biri smokers, whereas others are seen with whatsoever type of smoking.

Tell-tale signs of smoking

1. Stains

   1. Nails and fingers: Nails and fingers of smokers may take a yellowish stain due to repeated exposure to smoke and tar in smoke.

   2. Moustaches: Moustaches specially is elderly with white hair evidence a clear blueprint of yellowing in centre showing chronic exposure to smoke [Figure 1].

      

      Moustaches of an elderly person showing yellowish stain more in the center where smoke is exhaled from nose, a sure sign of heavy smoking

   3. Lips: Lips take a blueish-black discoloration in heavy smokers.

   4. Teeth: Teeth of smokers show dark-brown black staining from within and xanthous discoloration from exterior.

2. Burns

   1. Clothes: 'Chingari sign': Dress of biri smokers take numerous holes due to sparks (Chingari in Hindi) arising from called-for of biris over many months [Figure ii].

      

      Shirt of a patient showing multiple tiny holes produced by the sparks ('Chingari' in Hindi) originating from the Biri smoking (Biri is tobacco rolled in Tendu eaves). It is the most prevalent grade of smoking in India and this sign is called 'Chingari Sign' seen only in Biri smokers

   2. Fingers: Fingers of biri smokers may show burn marks due to repeated exposure to matchsticks used to burn down biris.

3. Peel changes

   1. Premature wrinkling: 'Crows feet', 'cobblestone wrinkles', 'smoker'southward face': The term smoker'southward face up was coined by Dr. Douglas Model in 1905 in an article published in British Medical Periodical.[1] His observation was that half of the long-term smokers (>10 years) had like skin features in face irrespective of age, dominicus exposure, or weight. Toxins from smoke caused constriction of blood vessels, presence of carbon monoxide reduced oxygen delivery to peel, and direct exposure of facial skin to fume caused dryness and irritation. In addition, nicotine has some diuretic outcome to reduce the peel moisture. Crow's feet [Effigy 3a] is the prominent lines and wrinkles starting from the corner of the eyes. Cobblestone wrinkles [Effigy 3b] are wrinkles that run downwardly at the back of the cervix. Smokers besides produce matrix metalloproteinase in backlog, which degrades collagen and skin loses elasticity equally a result.[ii]

      

      a: A typical "smoker's face" showing dryness of pare, wrinkles originating from the sides of eyelids running up to cheek chosen "crow's feet", wrinkles in front of the ears, and wrinkles running down the neck behind the ears

      

      Cobblestone-shaped wrinkles in the side and back of the neck of a smoker, a feature of heavy smoking over prolonged duration

   2. Nodular elastosis of peel with comedone formation: "Favre–Racouchot syndrome" [Figure 4].

      

      Favre–Racouchot syndrome: showing multiple open and closed comedones (black heads) over brow and furrowed wrinkled skin, produced by chronic sun exposure and heavy smoking

      The illness was originally described by Favre in 1932 and reviewed in item by Favre and Racouchot in 1951.[3,four] This illness is a cosmetic business organization and is caused by chronic excessive exposure to ultraviolet (UV) light in sun and is strongly associated with heavy cigarette smoking.[5] The association with smoking has been found to be even stronger than UV light.

      Multiple open and closed comedones are present in the periorbital and temporal areas with yellowish discoloration, yellowish nodules, atrophy, wrinkles, and furrows. The eruption is normally bilaterally symmetrical. No inflammation is present, unlike the comedones seen in acne vulgaris.[half-dozen]

4. Smell of smoke

   1. Heavy smokers have a typical smell of smoke in their clothes, jiff, hands, and can easily be detected by this smell. The smell may vary depending on the type of cigarette they employ. Then, if in uncertainty regarding the history using your smelling power may exist worthwhile, especially in adolescents.

Association of these signs with diseases

Facial wrinkling and association with chronic obstructive pulmonary disease (COPD):[7] In a recent study on chronic smokers, the investigators found statistically significant correlations between facial wrinkling and both low FEV_one and extensive disease on computed tomography (CT). The authors advise that genetic susceptibility might exist the mechanism behind this correlation: Smoking might activate metalloproteinases in susceptible individuals, or such individuals might accept defective repair mechanisms affecting both pare and lungs. If we are able to notice the signs in pare such as Crow'southward feet on face up in smokers at an early age, we can warning these patients regarding high likelihood of development of COAD considering of mutual proposed mechanism for both processes, that is, devastation of airways and wrinkling of confront by activation of metalloproteinases by smoking. Nosotros can also get their pulmonary office tests or chest CT to notice COAD at an early stage.

REFERENCES

ii. Lahmann C, Bergemann J, Harrison G, Young AR. Matrix metalloproteinase-1 and skin ageing in smokers. Lancet. 2001;357:935–half dozen. [PubMed] [Google Scholar]

three. Favre M. A reason for some localized pilosebaceous units on the face. Bull Soc Fr Dermatol Syph. 1932;39:93–6. [Google Scholar]

4. Favre M, Racouchot J. Nodular cutaneous elasteidosis with cysts and comedones. Ann Dermatol Syphiligr (Paris) 1951;78:681–702. [PubMed] [Google Scholar]

v. Keough GC, Laws RA, Elston DM. Favre-Racouchot syndrome: A case for smokers' comedones. Arch Dermatol. 1997;133:796–7. [PubMed] [Google Scholar]

6. Patterson WM, Flim-flam Medico, Schwartz RA. Favre-Racouchot illness. Int J Dermatol. 2004;43:167–9. [PubMed] [Google Scholar]

vii. Patel BD, Loo WJ, Tasker AD, Screaton NJ, Burrows NP, Silverman EK, et al. Smoking related COPD and facial wrinkling: Is there a mutual susceptibility? Thorax. 2006;61:568–71. [PMC complimentary article] [PubMed] [Google Scholar]

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Articles from Lung India : Official Organ of Indian Chest Society are provided here courtesy of Wolters Kluwer -- Medknow Publications

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3644846/

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