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?
C. Lichen Planus.
D. Squamous cell carcinoma.
- 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.
- 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