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This chapter is set out as follows: Aetiology History Clinical findings Images Investigations Management Aetiology OL affects about 1% of the population There is a strong association with tobacco smoking (six times more common in smokers than non-smokers) and alcohol intake It usually appears in middle-aged and elderly individuals, and is rare under the age of 30 History Lesions are asymptomatic Clinical findings The earliest lesion of OL is a non-palpable, white and faintly translucent macule