Your patient has been using chewing tobacco for 10 years.On physical examination,you observe a white ulceration surrounded by erythematous base on the side of his tongue.The clinician should recognize that very often this is:

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The most likely diagnosis based on the description is squamous cell carcinoma, which is a common malignancy associated with chewing tobacco use. The white ulceration and erythematous base are common features of squamous cell carcinoma. Malignant melanoma typically presents as a dark, irregularly shaped lesion, while aphthous ulceration is a benign condition that usually resolves on its own. Behcet's syndrome is a rare autoimmune disorder that can cause oral ulcers, but it is not associated with chewing tobacco use.

Your Patient Has Been Using Chewing Tobacco for 10 Years