Question
A 54 year old male,with a history of chewing tobacoo since 20 years presented with a white patch over the tongue.
On examination a whitish patch was seen on the dorsum of the tongue,bilaterally,which could not be wiped off.What is the most probable diagnosis?
A. Leukoplakia.
B. Candidiasis.
C. Lichen Planus.
D. Squamous cell carcinoma.
Show Answer
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Correct Answer » A
Explanation
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Ans:A. Leukoplakia.
Oral leukoplakia
- It is a white patch or plaque that cannot be rubbed off, cannot be characterized clinically or histologically as any other condition.
- Causative factors: tobacco use, alcohol consumption, chronic irritation, chronic cheek biting; ill-fitting dentures,candidiasis, vitamin deficiency, and possibly a virus.
- OL is considered to be potentially malignant, with a transformation rate from 0.6 to 20%..
- OL is classified in two main types: homogeneous type which appears as a flat white lesion and non-.homogeneous type which includes speckled, nodular and verrucous leukoplakia . The speckled type is a white and red lesion, with a predominantly white surface.
- In all cases, the relative risk of malignant potential is determined by the presence of epithelial dysplasia upon histological examination.
- Surgical excision of oral leukoplakia (OL) may be considered.
- Frequent clinical observation accompanied by photographic records is recommended.
- Oral Candidiasis: It is characterized by a patches of pseudomembranous white slough that can be easily wiped away to reveal erythematous, and sometimes minimally bleeding, mucosa beneath.
Lichen Planus
- The reticular form is the most common type. It presents as interlacing white keratotic lines (known as Wickham’s striae) with an erythematous border.
- Erosive form is the second most common type. It presents as a mix of erythematous and ulcerated areas surrounded by finely radiating keratotic striae
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