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Oral candidiasis: Oral hairy leukoplakia: Syphlytic leukoplakia Immunologic: Lichen planus: Lichenoid reaction (e.g. Lupus erythematosus, Graft versus host disease, Drug-induced lichenoid reaction) Psoriasis: Idiopathic and smoking related: Leukoplakia Smoker's keratosis (Stomatitis nicotina) Others e.g. Smokeless tobacco keratosis ("tobacco ...
Lichen planus may be categorized as affecting mucosal or cutaneous surfaces.. Cutaneous forms are those affecting the skin, scalp, and nails. [10] [11] [12]Mucosal forms are those affecting the lining of the gastrointestinal tract (mouth, pharynx, esophagus, stomach, anus), larynx, and other mucosal surfaces including the genitals, peritoneum, ears, nose, bladder and conjunctiva of the eyes.
The differential diagnosis is with leukoplakia, oral candidiasis, oral lichen planus, white sponge nevus, morsicatio buccarum, [3] hereditary benign intraepithelial dyskeratosis and dyskeratosis congenita.
Lichen planus: A chronic inflammatory disease with different forms of oral presentations. The most classic appearance of lichen planus is the presence of white streaks in inner cheek, tongue, and gum. Desquamative gingivitis can be seen in patients with lichen planus. Biopsy is done for definitive diagnosis of lichen planus. [18] [23]
Desquamative gingivitis is a descriptive clinical term, not a diagnosis. [1] Dermatologic conditions cause about 75% of cases of desquamative gingivitis, and over 95% of the dermatologic cases are accounted for by either oral lichen planus or cicatricial pemphigoid. [1]
In pseudomembraneous candidiasis, the membranous slough can be wiped away to reveal an erythematous surface underneath. This is helpful in distinguishing pseudomembraneous candidiasis from other white lesions in the mouth that cannot be wiped away, such as lichen planus, oral hairy leukoplakia. Erythematous candidiasis can mimic geographic tongue.
Lichenoid eruptions are dermatoses related to the unique, common inflammatory disorder lichen planus, which affects the skin, mucous membranes, nails, and hair. [74] [75] [76] Annular lichen planus Lichen planus actinicus; Atrophic lichen planus; Bullous lichen planus (vesiculobullous lichen planus) Erosive lichen planus
Diagnosis is mainly clinical, based on the history and clinical appearance. The differential diagnosis includes other oral white lesions such as Leukoplakia, squamous cell carcinoma, oral candidiasis, lichen planus, white sponge nevus and contact stomatitis. [7] In contrast to pseudomembraneous candidiasis, this white patch cannot be wiped off. [7]