DIFFERENTIAL Diagnoses for White lesions in oral cavity

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DIFFERENTIAL Diagnoses for White lesions in oral cavity

Candidiasis | Oral Hairy Leucoplakia | Lichen planus | HIV | EBV | Psoriasis | Methotrexate | NBUVB
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Leukoplakia, a precancerous condition that represents hyperplasia of the squamous epithelium and is particularly common in smokeless tobacco users. Leukoplakia presents as a white patch or plaque with changes in the mucosal surface texture. About 1% to 20% of lesions will progress to cancer over 10 years. The patient should be counseled to stop chewing tobacco.
Candida The plaque can easily be scraped off, and if the diagnosis is uncertain, a potassium hydroxide smear can be done on the scrapings, which will show budding yeasts with or without pseudohyphae.
Lichen planus is a disease of unknown cause that occurs on the skin, nails, and mucous membranes in middle-aged adults. Oral lesions may be the only manifestations. It is typically characterized by a network of white, lacy-appearing hypertrophic mucosa on the buccal mucosa, gingiva, and tongue. Additional clinical presentations include papular, atrophic, and painful erosive lesions.

Oral hairy leukoplakia is characterized by white, corrugated, painless plaques that typically develop on the lateral tongue but also occur on the floor of the mouth, palate, and buccal mucosa. Unlike the plaque due to candidiasis, the plaque caused by oral hairy leukoplakia cannot be scraped off.

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