Plasma Cell Stomatitis Associated With Khat (Catha Edulis): A Brief Review

Plasma cell stomatitis (PCS), an uncommon condition, is characterized by massive and dense infiltration of plasma cells into the connective tissue. The etiology of PCS is unclear, but this condition is believed to be an immunological reaction to certain allergens present in chewing gum, flavoring mint, dentifrices and cinnamon flavoring products. Recently, plasma cell stomatitis has also been reported among habitual khat chewers. Khat, a psychostimulant herb, is cultivated and habitually chewed by millions of people in East Africa and the Arabian Peninsula as well as by immigrants in the west. This article aims to briefly review the current literature of the association of PCS with Khat use and to highlight the treatment approaches for such cases. A review of the literature using PUBMED and Google Scholar revealed ten cases of PCS linked to khat use, most of which were identified in Yemen, where khat chewing is highly prevalent. Interestingly, however, two of the ten cases were also reported in western countries; one was about Somali immigrant in the Denmark and the other was a Yemeni immigrant in the US. Treatment of Khat related-PCS includes cessation of the habit and oral hygiene prophylaxis. The rise of global immigration may potentially increase the incidence of PCS and other khat-related oral lesions worldwide. Therefore, recognition of this habit and its implications on oral health should be emphasized.