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Larger white patches are more likely to undergo malignant transformation than smaller lesions. [3] White patches which have been present for a long period of time have a higher risk. [3] Persons with a positive family history of cancer in the mouth. [3] Candida infection in the presence of dysplasia has a small increased risk. [3]
Smokeless tobacco keratosis (STK) [4] is a condition which develops on the oral mucosa (the lining of the mouth) in response to smokeless tobacco use. Generally it appears as a white patch, located at the point where the tobacco is held in the mouth. The condition usually disappears once the tobacco habit is stopped.
Transient lingual papillitis is generally diagnosed based on patient presentation, meaning where it is located in the mouth and how big the bump is. [8] The visual presentation can also accompany various signs and symptoms such as difficulty eating, having a "strawberry tongue", increased saliva production, and a burning or tingling sensation. [9]
Stomatitis nicotina is a diffuse white patch on the hard palate, usually caused by tobacco smoking, usually pipe or cigar smoking. [2] It is painless, [ 4 ] and it is caused by a response of the palatal oral mucosa to chronic heat.
Koplik's spots (also Koplik's sign) are a prodromic viral enanthem of measles manifesting two to three days before the measles rash itself. They are characterized as clustered, white lesions on the buccal mucosa (opposite the upper 1st & 2nd molars ) and are pathognomonic for measles . [ 2 ]
Leukoedema lesions disappear when the mucosa is stretched, which helps to differentiate it from other white lesions in the mouth. [2] The differential diagnosis is with leukoplakia , oral candidiasis , oral lichen planus , white sponge nevus , morsicatio buccarum , [ 3 ] hereditary benign intraepithelial dyskeratosis and dyskeratosis congenita.
It is characterised by presence of small blisters all over the limbs and the mouth. [18] Measles: A highly infectious condition which is caused by measles virus. It most commonly presents in young children who have not been vaccinated. It is characterised by presence of white spots (Koplik's spots) which rupture to form ulcers on the palate. [18]
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.